Comparative Study of Tacrolimus and Short-Term Methotrexate: 2-Day versus 3-Day Methotrexate as Graft-versus-Host-Disease Prophylaxis after Umbilical Cord Blood Transplantation in Adults.
Biol Blood Marrow Transplant
; 26(2): 367-372, 2020 02.
Article
em En
| MEDLINE
| ID: mdl-31678538
ABSTRACT
Methotrexate (MTX) in combination with a calcineurin inhibitor has been commonly used for prophylaxis of graft-versus-host disease (GVHD) following umbilical cord blood transplantation (UCBT) in Japan. However, the appropriate prophylactic MTX dosage in UCBT has not been established to date. To determine the preferential GVHD prophylaxis in UCBT, this study retrospectively investigated the administration of short-term MTX for 2 days versus 3 days. Of 103 adult patients submitted to UCBT enrolled in the study, 73 received tacrolimus (TAC) with 2 days of MTX given at 10 mg/m2 on day 1 and 7 mg/m2 on day 3 (very short-term [vs] MTX), whereas 30 patients received TAC with 3 days of MTX given at 10 mg/m2 on day 1, 7 mg/m2 on day 3, and 7 mg/m2 on day 6 (short-term [s] MTX). In univariate analysis, neutrophil engraftment was shown to be significantly better (Pâ¯=â¯.039) in the vsMTX/TAC group. Among high-risk patients, the vsMTX/TAC group also exhibited earlier neutrophil engraftment (Pâ¯=â¯.042); however, the incidence of acute GVHD was higher in the vsMTX/TAC group (Pâ¯=â¯.035) on univariate analysis. In multivariate analysis, compared with sMTX/TAC, vsMTX/TAC was associated with lower risk of relapse (hazard ratio, .27; 95% confidence interval, .11 to .64; Pâ¯=â¯.003) . These results suggest that vsMTX/TAC can be appropriate GVHD prophylaxis after UCBT, especially in higher-risk patients.
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Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Transplante de Células-Tronco de Sangue do Cordão Umbilical
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Doença Enxerto-Hospedeiro
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Adult
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Humans
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article