Effect of methotrexate dose in graft-versus-host disease prophylaxis after single-unit cord blood transplantation in adult acute myeloid leukemia View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-02-21

AUTHORS

Seitaro Terakura, Yachiyo Kuwatsuka, Junichi Sugita, Satoshi Takahashi, Yukiyasu Ozawa, Kazutaka Ozeki, Satoshi Yoshioka, Hirohisa Nakamae, Toshiro Kawakita, Masashi Sawa, Satoshi Morishige, Yuho Najima, Yuna Katsuoka, Emiko Sakaida, Yasuji Kouzai, Takafumi Kimura, Tatsuo Ichinohe, Takahiro Fukuda, Yoshiko Atsuta, Makoto Murata, Takanori Teshima

ABSTRACT

To investigate the association between methotrexate (MTX) dosage and engraftment, graft-versus-host disease (GVHD) incidence, and survival in umbilical cord blood transplantation (UCBT), we compared transplant outcomes after UCBT with various GVHD prophylaxis regimens, using registry data with additional data collection. Patients transplanted for acute myeloid leukemia with a calcineurin inhibitor (CNI) and either MTX or mycophenolate mofetil (MMF) combination were selected. In total, 888 single-unit UCBTs (MTX15–10–10, 415; MTX10–7–7, 294; MTX5–5–5, 71; MMF, 108) were included. In multivariate analyses with MTX15–10–10 as the reference, the likelihood of neutrophil and platelet engraftment was significantly worse in the MTX10–7–7 group, and similarly better in MMF group compared with MTX15–10–10. All variables including CyA vs Tac and 4-group GVHD prophylaxis became significant for the risk of grade II–IV acute GVHD in the final multivariate model. We observed significant additional effects of combined MTX dose in the Tac group, which were larger with lower MTX dose and MMF. No significant difference was observed in survival risk among GVHD prophylaxis groups. Despite the potential background differences in the combined CNI and conditioning regimen, we conclude that the recommended GVHD prophylaxis is a combination of CyA plus MTX15–10–10 or Tac plus MMF. More... »

PAGES

840-850

References to SciGraph publications

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  • Journal

    TITLE

    International Journal of Hematology

    ISSUE

    6

    VOLUME

    113

    Author Affiliations

  • Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, 466-8560, Nagoya, Aichi, Japan
  • Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
  • Department of Hematology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
  • Division of Molecular Therapy, The Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
  • Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
  • Department of Hematology and Oncology, Konan Kosei Hospital, Konan, Japan
  • Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
  • Department of Hematology, Osaka City University Hospital, Osaka, Japan
  • Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
  • Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
  • Division of Hematology and Oncology, Department of Medicine, Kurume University Hospital, Kurume, Japan
  • Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
  • Department of Hematology, National Hospital Organization Sendai Medical Center, Sendai, Japan
  • Department of Hematology, Chiba University Hospital, Chiba, Japan
  • Department of Transfusion Medicine, Tokyo Metropolitan Tama Medical Center, Fuchu, Japan
  • Preparation Department, Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan
  • Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  • Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
  • Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s12185-021-03097-8

    DOI

    http://dx.doi.org/10.1007/s12185-021-03097-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1135554464

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33611725


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