TY - JOUR
T1 - Cyclosporine alone vs cyclosporine plus methotrexate for post-transplant immunosuppression after HLA-identical sibling bone marrow transplantation
T2 - A randomized prospective study
AU - Lee, K. H.
AU - Choi, S. J.
AU - Lee, J. H.
AU - Kim, S.
AU - Seol, M.
AU - Lee, Y. S.
AU - Kim, W. K.
AU - Lee, J. S.
AU - Lee, J. H.
PY - 2004/10
Y1 - 2004/10
N2 - 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.
AB - 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.
KW - Cyclosporine
KW - HLA-identical sibling BMT
KW - Methotrexate
KW - Post-transplant immunosuppression
UR - http://www.scopus.com/inward/record.url?scp=5044249076&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=5044249076&partnerID=8YFLogxK
U2 - 10.1038/sj.bmt.1704624
DO - 10.1038/sj.bmt.1704624
M3 - Article
C2 - 15300231
AN - SCOPUS:5044249076
SN - 0268-3369
VL - 34
SP - 627
EP - 636
JO - Bone marrow transplantation
JF - Bone marrow transplantation
IS - 7
ER -