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学科主题: 临床医学
题名:
First-Line Therapy for Chronic Graft-versus-Host Disease that Includes Low-Dose Methotrexate Is Associated with a High Response Rate
作者: Wang, Yu; Xu, Lan-ping; Liu, Dai-hong; Chen, Huan; Chen, Yu-hong; Han, Wei; Liu, Kai-yan; Huang, Xiao-jun
关键词: Hematopoietic stem cell transplantation ; Allogeneic ; Methotrexate ; Chronic graft-versus-host disease
刊名: BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
发表日期: 2009-04-01
DOI: 10.1016/j.bbmt.2008.12.493
卷: 15, 期:4, 页:505-511
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Hematology ; Immunology ; Transplantation
研究领域[WOS]: Hematology ; Immunology ; Transplantation
关键词[WOS]: STEM-CELL TRANSPLANTATION ; MARROW TRANSPLANTATION ; SALVAGE THERAPY ; CYCLOSPORINE ; PROPHYLAXIS ; THALIDOMIDE ; MECHANISMS ; TACROLIMUS
英文摘要:

We report the results of low-dose methotrexate (MTX) as first-line therapy mostly in combination with other immunosuppressive agents in patients with chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Between November 2001 and March 2008,86 patients with cGVHD after allo-HSCT received low-dose MTX therapy until a complete or partial response (CR, PR) was achieved, or until treatment failure or intolerable side effects were found. The median time from HSCT to the start of MTX was 154 (range: 80-993) days. The median number of MTX administrations was 4 (range: 2-18). The overall response rate among all enrolled patients was 83% (71 of 86 patients). The response rate for GVHD involving various organs was 90% (45 of 50) in the skin, 75% (39 of 52) in the liver, 42% (5 of 12) in the mouth, 3 of 7 in the eye, and 2 of 2 in the gut. In addition, MTX treatment allowed for a significant reduction in the prednisone dosage (median 90%) from 20 (2.5-100) mg at the start of MTX administration to 5 (0-30) mg 1 month after MTX was last used. Multivariate analysis showed that the only significant factor related to higher CR rate was sole organ involvement (P = .007). Grade 3 toxicities occurred in only 3 patients presenting cytopenias or oral mucositis. From this analysis, MTX appears to be a well-toletated, effective, and inexpensive agent when used as a first-line treatment in combination with other immunosuppressive agents for cGVHD, especially for skin or sole organ involvement without concomitant thrombocytopenia.

语种: 英语
所属项目编号: 30725038 ; 2006AA02Z4A0 ; IRT 0702
项目资助者: National Outstanding Young Scientist&prime ; s Foundation of China ; FE-tech Research and Development Program of China ; Program for Innovative Research Team in University
WOS记录号: WOS:000264616000014
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/51170
Appears in Collections:北京大学第二临床医学院_血液科_期刊论文

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作者单位: Peking Univ, Peoples Hosp, Inst Hematol, Beijing 100044, Peoples R China

Recommended Citation:
Wang, Yu,Xu, Lan-ping,Liu, Dai-hong,et al. First-Line Therapy for Chronic Graft-versus-Host Disease that Includes Low-Dose Methotrexate Is Associated with a High Response Rate[J]. BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION,2009,15(4):505-511.
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