A Comparison of Peripheral and Centrally Collected Cyclosporine A Blood Levels in Pediatric Patients Undergoing Stem Cell Transplant

PURPOSE/OBJECTIVES: To measure differences in cyclosporine A (CSA) trough concentrations from blood collected as a peripheral sample and from a CSA-uncontaminated (naive) lumen of a double-lumen central line. DESIGN: Prospective, comparative study. SETTING: Pediatric university teaching hospital in metropolitan Australia. SAMPLE: 71 paired central and peripheral CSA blood samples from a convenience sample of 14 pediatric allogeneic stem cell transplant recipients receiving IV CSA as prophylaxis or treatment for graft-versus-host disease. Ages ranged from 2 months to 14 years, 5 months. METHODS: Comparing blood samples collected from a peripheral site and a CSA-naive lumen of a double-lumen central line. Data were analyzed using a paired student t test and calculation of the 95% confidence interval of the concentration ratio from different sampling sites. MAIN RESEARCH VARIABLES: Site of blood sampling and CSA trough concentrations. FINDINGS: No significant difference existed between CSA concentration in samples collected from the different sites in children receiving intermittent infusions of CSA (p = 0.13). The 95% confidence interval of the CSA concentration ratio was 0.92 1.04. CONCLUSIONS: When CSA is administered on an intermittent dosing schedule, comparable CSA trough concentrations can be determined from blood collected via the CSA-naive lumen of a double-lumen central line or at a peripheral sampling site. IMPLICATIONS FOR NURSING: Pediatric allogeneic stem cell transplant recipients who require regular CSA trough concentrations no longer will require peripheral blood samples when receiving an intermittent dosing schedule.