| 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)
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