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Graft-Versus-Host Disease

Methotrexate vs Cyclosporin A as a single agent for graft-versus-host disease prophylaxis in pediatric patients with hematological malignancies undergoing allogeneic bone marrow transplantation from HLA-identical siblings: a single-center analysis in Japan

Bone Marrow Transplantation volume 32, pages 171–176 (2003)Cite this article

Summary:

The efficacy of methotrexate (MTX) as a single graft-versus-host disease (GVHD) prophylaxis agent was compared to that of cyclosporin A (CSA) in 62 pediatric patients (median age: 8 years) with hematological malignancies who had undergone bone marrow transplantation (BMT) from HLA-identical sibling donors at National Kyushu Cancer Center since 1977. In all, 30 patients received MTX by intravenous bolus injection, with a dose of 15 mg/m2 on day +1, followed by 10 mg/m2 on days +3, +6, and +11, and then once a week until day +100. A total of 32 patients were treated with CSA, which was given intravenously in the early stages and orally thereafter until day +100, and then gradually tapered and stopped 6 months after BMT. There were no differences between the groups in terms of rates of hematopoietic recovery after BMT. The probabilities of acute GVHD (grades II–IV) and chronic GVHD were 29.6 vs 40.6% (P=0.294) and 19 vs 20% (MTX vs CSA), respectively. Relapse rates and event-free survival were identical. These results suggest that MTX and CSA were equally effective when given after BMT in Japanese pediatric patients with hematological malignancies. Since MTX was given over a shorter time than CSA, it might be more practical in the management of such patients.

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Acknowledgements

We are grateful to the nursing staff at National Kyushu Cancer Center during the study period. We thank the resident doctors for their contribution in caring for the transplanted patients.

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Authors and Affiliations

  1. Section of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan

    Y Koga, Y Nagatoshi, Y Kawano & J Okamura

  2. Department of Pediatrics, University of Kagoshima, Kagoshima, Japan

    Y Kawano

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  1. Y Koga
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Koga, Y., Nagatoshi, Y., Kawano, Y. et al. Methotrexate vs Cyclosporin A as a single agent for graft-versus-host disease prophylaxis in pediatric patients with hematological malignancies undergoing allogeneic bone marrow transplantation from HLA-identical siblings: a single-center analysis in Japan. Bone Marrow Transplant 32, 171–176 (2003). https://doi.org/10.1038/sj.bmt.1704051

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