Nephrotoxicity of Cyclosporin a after Allogeneic Marrow Transplantation

Abstract

CYCLOSPORIN A, a fungal metabolite, is a potent new immunosuppressive drug1 , 2 that has been reported to prevent or ameliorate rejection of kidney and liver allografts3 4 5 and graft-versus-host disease after allogeneic marrow transplantation.6 , 7 A potentially harmful side effect of therapy with cyclosporin A is renal toxicity. Previous reports of nephrotoxicity after cyclosporin A have emphasized the mild and transient elevations of blood urea nitrogen (BUN) and creatinine.3 4 5 6 7 8 9 We now describe a distinct histologic constellation of glomerular thromboses and severe tubular damage, which correlated with the clinical course and laboratory findings of severe renal failure in three recipients of allogeneic marrow who . . .