Details

Autor(en) / Beteiligte

• Shiratori, Souichi
• Ohigashi, Hiroyuki
• Takahashi, Shuichiro
• Ara, Takahide
• Goto, Hideki
• Nakagawa, Masao
• Sugita, Junichi
• Onozawa, Masahiro
• Kahata, Kaoru
• Endo, Tomoyuki
• Hashimoto, Daigo
• Teshima, Takanori

Titel

Reduced dose of MTX for GVHD prophylaxis promotes engraftment and decreases non-relapse mortality in umbilical cord blood transplantation

Ist Teil von

• Annals of hematology, 2020-03, Vol.99 (3), p.591-598

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2020

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Although a combination of calcineurin inhibitor and methotrexate (MTX) is used for graft-versus-host disease (GVHD) prophylaxis in umbilical cord blood transplantation (CBT), optimal dose of MTX for CBT remains to be determined. We conducted a retrospective study to evaluate the safety and efficacy of standard-dose MTX (St-MTX, 15 mg/m 2 on day 1 and 10 mg/m 2 on days 3 and 6) and mini-dose MTX (Mini-MTX, 5 mg/m 2 on days 1, 3 and 6) for GVHD prophylaxis in patients who underwent single unit CBT against hematological malignancies. Thirty-two and 26 patients received St-MTX and Mini-MTX, respectively. Cumulative incidence of neutrophil engraftment was significantly higher in the Mini-MTX group than in the St-MTX group (88.5% vs 65.6%, P  = 0.00448). Cumulative incidences of grade II to IV and grade III to IV of acute graft-versus-host disease (GVHD) were 34.4% and 6.2% in the St-MTX group, and 34.6% and 7.7% in the Mini-MTX group with no statistical significance. One-year non-relapse mortality (NRM) was significantly lower in the Mini-MTX group compared to the St-MTX group (31.2% vs 3.8%, P  = 0.00938), whereas relapse rate was not different between the groups. Multivariate analysis also indicated that Mini-MTX significantly improved engraftment (HR, 0.5359; 95% CI, 0.3082 to 0.9318; P  = 0.0270) and reduced NRM (HR, 0.117; 95% CI, 0.0151 to 0.9067; P  = 0.040). Our study suggests that GVHD prophylaxis using Mini-MTX in CBT is feasible and associated with improvement of engraftment and reduction in NRM.