Prognostic impact of the dosage of methotrexate combined with tacrolimus for graft-versus-host disease prophylaxis after cord blood transplantation

The optimal dosage of methotrexate (MTX) for graft-versus-host disease (GVHD) prophylaxis after cord blood transplantation (CBT) has not been well elucidated. Therefore, we conducted a retrospective study comparing a mini-MTX group (5 mg/m 2 on day 1, 3 and 6) to a short-MTX group (10 mg/m 2 on day...

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Bibliographic Details
Published in:International journal of hematology 2021-08, Vol.114 (2), p.252-262
Main Authors: Adachi, Miwa, Yokota, Daisuke, Hirata, Hiroya, Koyauchi, Katsumi, Dohtan, Satoshi, Oka, Shinichiro, Sakamoto, Nami, Takaba, Masamitsu, Takemura, Tomonari, Nagata, Yasuyuki, Naito, Kensuke, Ono, Takaaki
Format: Article
Language:English
Subjects:
Blood
Cord blood
Disease prevention
Dosage
Graft rejection
Graft versus host disease
Graft-versus-host reaction
Grafting
Grafts
Hematology
Leukocytes (neutrophilic)
Medicine
Medicine & Public Health
Methotrexate
Multivariate analysis
Neutrophils
Oncology
Original Article
Prophylaxis
Survival
Tacrolimus
Transplantation
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Summary:The optimal dosage of methotrexate (MTX) for graft-versus-host disease (GVHD) prophylaxis after cord blood transplantation (CBT) has not been well elucidated. Therefore, we conducted a retrospective study comparing a mini-MTX group (5 mg/m 2 on day 1, 3 and 6) to a short-MTX group (10 mg/m 2 on day 1 and 7 mg/m 2 on day 3 and 6) after CBT. Sixty-three patients were classified as the mini-MTX group and 20 as the short-MTX group. The median time and cumulative incidence of neutrophil engraftment did not vary between the two groups. The cumulative incidence of grade 2–4 and grade 3–4 acute GVHD was similar in both groups. Overall survival in the mini-MTX group was significantly lower than in the short-MTX group (46.9% vs. 88.7% at 1 year, p  
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-021-03161-3