Cyclosporine alone vs cyclosporine plus methotrexate for post-transplant immunosuppression after HLA-identical sibling bone marrow transplantation: A randomized prospective study

K. H. Lee, S. J. Choi, J. H. Lee, S. Kim, M. Seol, Y. S. Lee, W. K. Kim, J. S. Lee, J. H. Lee

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

The role of methotrexate (MTX), given with cyclosporine (CS), after HLA-identical sibling bone marrow transplantation needs to be defined. In all, 80 patients with hematologic malignancies were enrolled in a prospective randomized trial. All were given BuCy conditioning. The 40 patients in the CS arm received CS 3mg/kg/day intravenously, with subsequent oral dosing. Patients in the CS + MTX arm received, in addition to CS, MTX intravenously, 15 mg/m2 on day 1, and 10 mg/m2 on days 3, 6, and 11. Transplantation-related mortality was low in both groups of patients (13 vs 11 % for CS vs CS + MTX groups, P=0.94). The CS group had a significantly higher frequency of chronic graft-versus-host disease (56 vs 32%, P = 0.05). After a median follow-up of 22.1 months (5.1-47.8 months), three of 30 vs 10 of 28 patients with acute leukemia/myelodysplastic syndrome (MDS) in CS group vs CS+MTX group relapsed (P=0.01) yielding better overall survival for patients with acute leukemia/MDS treated with CS (P = 0.02). After HLA-identical sibling bone marrow transplantation, immunosuppression with CS, with or without MTX, resulted in similarly low transplantation-related mortality. In acute leukemia/MDS, decreased relapse with patient survival prolongation was observed in the CS group.

Original languageEnglish (US)
Pages (from-to)627-636
Number of pages10
JournalBone marrow transplantation
Volume34
Issue number7
DOIs
StatePublished - Oct 1 2004

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Bone Marrow Transplantation
Methotrexate
Immunosuppression
Cyclosporine
Siblings
Prospective Studies
Transplants
Myelodysplastic Syndromes
Leukemia
Arm
Transplantation
Survival
Mortality
Graft vs Host Disease
Hematologic Neoplasms

Keywords

  • Cyclosporine
  • HLA-identical sibling BMT
  • Methotrexate
  • Post-transplant immunosuppression

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Cyclosporine alone vs cyclosporine plus methotrexate for post-transplant immunosuppression after HLA-identical sibling bone marrow transplantation : A randomized prospective study. / Lee, K. H.; Choi, S. J.; Lee, J. H.; Kim, S.; Seol, M.; Lee, Y. S.; Kim, W. K.; Lee, J. S.; Lee, J. H.

In: Bone marrow transplantation, Vol. 34, No. 7, 01.10.2004, p. 627-636.

Research output: Contribution to journalArticle

Lee, K. H. ; Choi, S. J. ; Lee, J. H. ; Kim, S. ; Seol, M. ; Lee, Y. S. ; Kim, W. K. ; Lee, J. S. ; Lee, J. H. / Cyclosporine alone vs cyclosporine plus methotrexate for post-transplant immunosuppression after HLA-identical sibling bone marrow transplantation : A randomized prospective study. In: Bone marrow transplantation. 2004 ; Vol. 34, No. 7. pp. 627-636.
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