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学科主题: 临床医学
题名:
Low-dose methotrexate may preserve a stronger antileukemic effect than that of cyclosporine after modified donor lymphocyte infusion in unmanipulated haploidentical HSCT
作者: Yan, Chen-Hua; Xu, Lan-Ping; Liu, Dai-hong; Chen, Huan; Wang, Yu; Wang, Jing-zhi; Wang, Feng-rong; Han, Wei; Liu, Kai-Yan; Huang, Xiao-Jun
关键词: cyclosporine ; graft-versus-host disease ; graft-versus-leukemia effect ; haploidentical hematopoietic stem cell transplantation ; methotrexate ; modified donor lymphocyte infusion
刊名: CLINICAL TRANSPLANTATION
发表日期: 2015-07-01
DOI: 10.1111/ctr.12561
卷: 29, 期:7, 页:594-605
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Surgery ; Transplantation
研究领域[WOS]: Surgery ; Transplantation
关键词[WOS]: STEM-CELL TRANSPLANTATION ; VERSUS-HOST-DISEASE ; BONE-MARROW-TRANSPLANTATION ; ACUTE MYELOID-LEUKEMIA ; PERIPHERAL-BLOOD LYMPHOCYTES ; HEMATOLOGICAL MALIGNANCIES ; RHEUMATOID-ARTHRITIS ; LEUKOCYTE INFUSIONS ; RISK-FACTORS ; RELAPSE
英文摘要:

To compare the impacts of low-dose methotrexate (MTX) with cyclosporine (CSA) on graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL) effect after haploidentical modified donor lymphocyte infusion (DLI). Fifty-five consecutive patients who had relapsed acute leukemia after haploidentical hematopoietic stem cell transplantation (HSCT) and received modified DLI were retrospectively studied. Forty-one patients received CSA and 14 received low-dose MTX after DLI to prevent DLI-associated GVHD. The incidence of acute GVHD and grade 2-4 acute GVHD in MTX group showed a trend toward being higher than in CSA group (61.0% vs. 37.3%, p=0.198 and 61.0% vs. 35.5%, p=0.155). However, no significant difference in the incidence of grade 3-4 acute GVHD between two groups (p=0.982) was observed. Moreover, compared with CSA, patients treated with MTX had lower re-relapse rate (38.1% vs. 80.8%, p=0.029), better disease-free survival (DFS) (51.9% vs. 15.6%, p=0.06), and higher absolute lymphocyte counts at 30, 45, 60, and 90d after modified DLI (p<0.05). This study suggested that after haploidentical modified DLI, low-dose MTX is at least as effective as CSA in the prevention of DLI-associated GVHD and probably allowed stronger GVL effect than CSA. This phenomenon was probably due to a direct antitumor effect and a better reconstitution of lymphocytes after modified DLI induced by low-dose MTX.

语种: 英语
WOS记录号: WOS:000358204300005
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/62211
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, Inst Hematol, Peoples Hosp, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing 100044, Peoples R China

Recommended Citation:
Yan, Chen-Hua,Xu, Lan-Ping,Liu, Dai-hong,et al. Low-dose methotrexate may preserve a stronger antileukemic effect than that of cyclosporine after modified donor lymphocyte infusion in unmanipulated haploidentical HSCT[J]. CLINICAL TRANSPLANTATION,2015,29(7):594-605.
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