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. Author manuscript; available in PMC: 2017 May 18.
Published in final edited form as: Biol Blood Marrow Transplant. 2013 Dec 25;20(4):518–525. doi: 10.1016/j.bbmt.2013.12.565

Figure 3.

Figure 3

Eculizumab dosing optimization in HSCT patients with TMA. (A) Suggested eculizumab dose adjustments based on CH50 level and clinical TMA response. (B) Eculizumab induction and maintenance doses based on patient’s weight (modified from dosing schedule for children with aHUS [20]). CH50 should be monitored daily after the first eculizumab induction dose is given with the goal to maintain CH50 level of 0 to 3 CAE units that corresponds to a therapeutic eculizumab dose >99 μg/mL. If CH50 remains 0 to 3 CAE units after start of therapy, the induction dose should be given weekly until full resolution of hematologic parameters of TMA before advancing to maintenance schedule. If CH50 is ≥ 4 CAE units earlier than 7 days after starting therapy, an additional induction dose should be given. If CH50 raises again to ≥4 CAE units, the next dose should be increased by 300 mg to achieve a steady therapeutic level as soon as possible. The dose of eculizumab that maintains a CH50 level ≤3 CAE units is the required weekly induction dose for the particular patient. During maintenance therapy, CH50 should be monitored at least twice a week to ensure a therapeutic drug level.