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Reduced-dose methotrexate in combination with tacrolimus was associated with rapid engraftment and recovery from oral mucositis without affecting the incidence of GVHD

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Title: Reduced-dose methotrexate in combination with tacrolimus was associated with rapid engraftment and recovery from oral mucositis without affecting the incidence of GVHD
Authors: Matsukawa, Toshihiro Browse this author
Hashimoto, Daigo Browse this author
Sugita, Junichi Browse this author
Nakazawa, Seitarou Browse this author
Matsushita, Takae Browse this author
Kashiwazaki, Haruhiko Browse this author →KAKEN DB
Goto, Hideki Browse this author
Onozawa, Masahiro Browse this author →KAKEN DB
Kahata, Kaoru Browse this author
Fujimoto, Katsuya Browse this author
Endo, Tomoyuki Browse this author
Kondo, Takeshi Browse this author →KAKEN DB
Hashino, Satoshi Browse this author →KAKEN DB
Yamazaki, Yutaka Browse this author →KAKEN DB
Teshima, Takanori Browse this author →KAKEN DB
Keywords: GVHD prophylaxis
Methotrexate
Oral mucositis
Engraftment
Issue Date: Jul-2016
Publisher: Springer
Journal Title: International journal of hematology
Volume: 104
Issue: 1
Start Page: 117
End Page: 124
Publisher DOI: 10.1007/s12185-016-1996-0
PMID: 27119977
Abstract: Allogeneic hematopoietic stem cell transplantation is a curable treatment for hematological diseases. Graft-versus-host disease (GVHD) causes morbidity and mortality after HSCT. Methotrexate (MTX) is used for GVHD prophylaxis, but its appropriate dose remains unclear. In the present study, we compared the efficacy and toxicity of 15-10-10 MTX (day +1: 15 mg/m2; days +3 and +6: 10 mg/m2) with 10-7-7 MTX (day +1: 10 mg/m2; day +3 and +6: 7 mg/m2) in combination with tacrolimus. The cumulative incidence rates of grades II-IV acute GVHD, grades III-IV acute GVHD and chronic GVHD in the 15-10-10 MTX and 10-7-7 MTX groups did not differ to a statistically significant extent. The median time for neutrophil engraftment in the 15-10-10 MTX group was 16 days (range, 11-31 days), while that in the 10-7-7 group was 15 days (range, 12-19 days) (P = 0.024). Moreover, the median time for platelet recovery was significantly shorter in the 10-7-7 MTX group (22 days; range, 13-49 days) than that in the 15-10-10 MTX group (27 days; range, 9-405 days) (P = 0.027). The duration of oral mucositis was significantly shorter in the patients who received a reduced dose of MTX (median, 4.5 vs 13.0 days; P = 0.013). In conclusion, GVHD prophylaxis with a reduced dose of MTX was associated with earlier engraftment and earlier recovery from mucositis in comparison to a standard dose of MTX, without affecting the incidence of GVHD.
Rights: The final publication is available at link.springer.com
Type: article (author version)
URI: http://hdl.handle.net/2115/66415
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 豊嶋 崇徳

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