GVHD prophylaxis by tacrolimus and mini-MTX in single-unit CBT: a single institute experience
Tacrolimus (TAC) combined with short-term methotrexate (MTX) is widely used to prevent graft-versus-host disease (GVHD) in cord blood transplantation (CBT). As short-term MTX aggravates mucositis and delays engraftment, we reduced the dose of MTX, as previously reported in the non-CBT setting. Here,...
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| Veröffentlicht in: | International journal of hematology 2020-02, Vol.111 (2), p.278-283 |
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| creator | Fuji, Shigeo Tada, Yuma Nakata, Ryo Nakata, Keiichi Koike, Midori Kida, Shuhei Tsutsumi, Kazuhito Masaie, Hiroaki Yoshida, Hitoshi Ishikawa, Jun |
| description | Tacrolimus (TAC) combined with short-term methotrexate (MTX) is widely used to prevent graft-versus-host disease (GVHD) in cord blood transplantation (CBT). As short-term MTX aggravates mucositis and delays engraftment, we reduced the dose of MTX, as previously reported in the non-CBT setting. Here, we retrospectively analyze outcomes of 20 patients who received CBT from April 2017 to December 2018. All patients received TAC with mini-MTX as GVHD prophylaxis. Mini-MTX was administered at a dose of 5 mg/m
2
of MTX on days 1, 3 and 6 after CBT. Median age was 54.5 years. Median follow-up time in surviving patients was 396 days. The primary disease was acute leukemia (
n
= 12) or malignant lymphoma (
n
= 8). Three patients and 17 patients received myeloablative and reduced-intensity conditioning, respectively. Rate and median time to engraftment of neutrophils were 90.0% and 20.5 days, respectively. Cumulative incidences of grade II–IV and grade III–IV acute GVHD were 35.0% and 5.0%, respectively. At one year after CBT, the overall survival rate was 80.5%, cumulative incidence of relapse/progression was 15.0%, and non-relapse mortality rate was 5.0%. In conclusion, TAC with mini-MTX may be a promising GVHD prophylaxis regimen in single-unit CBT. |
| doi_str_mv | 10.1007/s12185-019-02762-3 |
| format | Article |
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2
of MTX on days 1, 3 and 6 after CBT. Median age was 54.5 years. Median follow-up time in surviving patients was 396 days. The primary disease was acute leukemia (
n
= 12) or malignant lymphoma (
n
= 8). Three patients and 17 patients received myeloablative and reduced-intensity conditioning, respectively. Rate and median time to engraftment of neutrophils were 90.0% and 20.5 days, respectively. Cumulative incidences of grade II–IV and grade III–IV acute GVHD were 35.0% and 5.0%, respectively. At one year after CBT, the overall survival rate was 80.5%, cumulative incidence of relapse/progression was 15.0%, and non-relapse mortality rate was 5.0%. In conclusion, TAC with mini-MTX may be a promising GVHD prophylaxis regimen in single-unit CBT.</description><identifier>ISSN: 0925-5710</identifier><identifier>EISSN: 1865-3774</identifier><identifier>DOI: 10.1007/s12185-019-02762-3</identifier><identifier>PMID: 31659626</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Cord blood ; Drug Therapy, Combination ; Graft vs Host Disease - mortality ; Graft vs Host Disease - prevention & control ; Graft-versus-host reaction ; Hematology ; Humans ; Leukemia ; Leukocytes (neutrophilic) ; Lymphoma ; Medicine ; Medicine & Public Health ; Methotrexate ; Methotrexate - administration & dosage ; Mucositis ; Oncology ; Original Article ; Prophylaxis ; Recurrence ; Retrospective Studies ; Survival Rate ; Tacrolimus ; Tacrolimus - administration & dosage ; Transplantation ; Treatment Outcome</subject><ispartof>International journal of hematology, 2020-02, Vol.111 (2), p.278-283</ispartof><rights>Japanese Society of Hematology 2019</rights><rights>International Journal of Hematology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-720cc18b46825aacc6ace4b2f51d67238dd364ebe80c3641ef32a63cc83072f3</citedby><cites>FETCH-LOGICAL-c465t-720cc18b46825aacc6ace4b2f51d67238dd364ebe80c3641ef32a63cc83072f3</cites><orcidid>0000-0001-5118-7950</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12185-019-02762-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12185-019-02762-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31659626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fuji, Shigeo</creatorcontrib><creatorcontrib>Tada, Yuma</creatorcontrib><creatorcontrib>Nakata, Ryo</creatorcontrib><creatorcontrib>Nakata, Keiichi</creatorcontrib><creatorcontrib>Koike, Midori</creatorcontrib><creatorcontrib>Kida, Shuhei</creatorcontrib><creatorcontrib>Tsutsumi, Kazuhito</creatorcontrib><creatorcontrib>Masaie, Hiroaki</creatorcontrib><creatorcontrib>Yoshida, Hitoshi</creatorcontrib><creatorcontrib>Ishikawa, Jun</creatorcontrib><title>GVHD prophylaxis by tacrolimus and mini-MTX in single-unit CBT: a single institute experience</title><title>International journal of hematology</title><addtitle>Int J Hematol</addtitle><addtitle>Int J Hematol</addtitle><description>Tacrolimus (TAC) combined with short-term methotrexate (MTX) is widely used to prevent graft-versus-host disease (GVHD) in cord blood transplantation (CBT). As short-term MTX aggravates mucositis and delays engraftment, we reduced the dose of MTX, as previously reported in the non-CBT setting. Here, we retrospectively analyze outcomes of 20 patients who received CBT from April 2017 to December 2018. All patients received TAC with mini-MTX as GVHD prophylaxis. Mini-MTX was administered at a dose of 5 mg/m
2
of MTX on days 1, 3 and 6 after CBT. Median age was 54.5 years. Median follow-up time in surviving patients was 396 days. The primary disease was acute leukemia (
n
= 12) or malignant lymphoma (
n
= 8). Three patients and 17 patients received myeloablative and reduced-intensity conditioning, respectively. Rate and median time to engraftment of neutrophils were 90.0% and 20.5 days, respectively. Cumulative incidences of grade II–IV and grade III–IV acute GVHD were 35.0% and 5.0%, respectively. At one year after CBT, the overall survival rate was 80.5%, cumulative incidence of relapse/progression was 15.0%, and non-relapse mortality rate was 5.0%. In conclusion, TAC with mini-MTX may be a promising GVHD prophylaxis regimen in single-unit CBT.</description><subject>Cord blood</subject><subject>Drug Therapy, Combination</subject><subject>Graft vs Host Disease - mortality</subject><subject>Graft vs Host Disease - prevention & control</subject><subject>Graft-versus-host reaction</subject><subject>Hematology</subject><subject>Humans</subject><subject>Leukemia</subject><subject>Leukocytes (neutrophilic)</subject><subject>Lymphoma</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methotrexate</subject><subject>Methotrexate - administration & dosage</subject><subject>Mucositis</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Prophylaxis</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Tacrolimus</subject><subject>Tacrolimus - administration & dosage</subject><subject>Transplantation</subject><subject>Treatment Outcome</subject><issn>0925-5710</issn><issn>1865-3774</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kMtOwzAQRS0EouXxAyyQJdYGP-JH2EGBFqmITYTYIMtxnOIqTUOcSO3fY0iBHasZzdy5V3MAOCP4kmAsrwKhRHGESYowlYIitgfGRAmOmJTJPhjjlHLEJcEjcBTCEmMicSIPwYgRwVNBxRi8TV9md7Bp1837tjIbH2C-hZ2x7bryqz5AUxdw5WuPnrJX6GsYfL2oHOpr38HJbXYNzW4Ul6HzXd856DaNa72rrTsBB6Wpgjvd1WOQPdxnkxmaP08fJzdzZBPBOyQptpaoPBGKcmOsFca6JKclJ4WQlKmiYCJxuVPYxoa4klEjmLWKYUlLdgwuBtv4x0fvQqeX676tY6KmLEkEVilNo4oOqvhcCK0rddP6lWm3mmD9BVQPQHUEqr-BahaPznfWfb5yxe_JD8EoYIMgxFW9cO1f9j-2n3-OgGQ</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Fuji, Shigeo</creator><creator>Tada, Yuma</creator><creator>Nakata, Ryo</creator><creator>Nakata, Keiichi</creator><creator>Koike, Midori</creator><creator>Kida, Shuhei</creator><creator>Tsutsumi, Kazuhito</creator><creator>Masaie, Hiroaki</creator><creator>Yoshida, Hitoshi</creator><creator>Ishikawa, Jun</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><orcidid>https://orcid.org/0000-0001-5118-7950</orcidid></search><sort><creationdate>20200201</creationdate><title>GVHD prophylaxis by tacrolimus and mini-MTX in single-unit CBT: a single institute experience</title><author>Fuji, Shigeo ; Tada, Yuma ; Nakata, Ryo ; Nakata, Keiichi ; Koike, Midori ; Kida, Shuhei ; Tsutsumi, Kazuhito ; Masaie, Hiroaki ; Yoshida, Hitoshi ; Ishikawa, Jun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-720cc18b46825aacc6ace4b2f51d67238dd364ebe80c3641ef32a63cc83072f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Cord blood</topic><topic>Drug Therapy, Combination</topic><topic>Graft vs Host Disease - mortality</topic><topic>Graft vs Host Disease - prevention & control</topic><topic>Graft-versus-host reaction</topic><topic>Hematology</topic><topic>Humans</topic><topic>Leukemia</topic><topic>Leukocytes (neutrophilic)</topic><topic>Lymphoma</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Methotrexate</topic><topic>Methotrexate - administration & dosage</topic><topic>Mucositis</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Prophylaxis</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Tacrolimus</topic><topic>Tacrolimus - administration & dosage</topic><topic>Transplantation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fuji, Shigeo</creatorcontrib><creatorcontrib>Tada, Yuma</creatorcontrib><creatorcontrib>Nakata, Ryo</creatorcontrib><creatorcontrib>Nakata, Keiichi</creatorcontrib><creatorcontrib>Koike, Midori</creatorcontrib><creatorcontrib>Kida, Shuhei</creatorcontrib><creatorcontrib>Tsutsumi, Kazuhito</creatorcontrib><creatorcontrib>Masaie, Hiroaki</creatorcontrib><creatorcontrib>Yoshida, Hitoshi</creatorcontrib><creatorcontrib>Ishikawa, Jun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Nucleic Acids Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>International journal of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fuji, Shigeo</au><au>Tada, Yuma</au><au>Nakata, Ryo</au><au>Nakata, Keiichi</au><au>Koike, Midori</au><au>Kida, Shuhei</au><au>Tsutsumi, Kazuhito</au><au>Masaie, Hiroaki</au><au>Yoshida, Hitoshi</au><au>Ishikawa, Jun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>GVHD prophylaxis by tacrolimus and mini-MTX in single-unit CBT: a single institute experience</atitle><jtitle>International journal of hematology</jtitle><stitle>Int J Hematol</stitle><addtitle>Int J Hematol</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>111</volume><issue>2</issue><spage>278</spage><epage>283</epage><pages>278-283</pages><issn>0925-5710</issn><eissn>1865-3774</eissn><abstract>Tacrolimus (TAC) combined with short-term methotrexate (MTX) is widely used to prevent graft-versus-host disease (GVHD) in cord blood transplantation (CBT). As short-term MTX aggravates mucositis and delays engraftment, we reduced the dose of MTX, as previously reported in the non-CBT setting. Here, we retrospectively analyze outcomes of 20 patients who received CBT from April 2017 to December 2018. All patients received TAC with mini-MTX as GVHD prophylaxis. Mini-MTX was administered at a dose of 5 mg/m
2
of MTX on days 1, 3 and 6 after CBT. Median age was 54.5 years. Median follow-up time in surviving patients was 396 days. The primary disease was acute leukemia (
n
= 12) or malignant lymphoma (
n
= 8). Three patients and 17 patients received myeloablative and reduced-intensity conditioning, respectively. Rate and median time to engraftment of neutrophils were 90.0% and 20.5 days, respectively. Cumulative incidences of grade II–IV and grade III–IV acute GVHD were 35.0% and 5.0%, respectively. At one year after CBT, the overall survival rate was 80.5%, cumulative incidence of relapse/progression was 15.0%, and non-relapse mortality rate was 5.0%. In conclusion, TAC with mini-MTX may be a promising GVHD prophylaxis regimen in single-unit CBT.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>31659626</pmid><doi>10.1007/s12185-019-02762-3</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-5118-7950</orcidid></addata></record> |
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| subjects | Cord blood Drug Therapy, Combination Graft vs Host Disease - mortality Graft vs Host Disease - prevention & control Graft-versus-host reaction Hematology Humans Leukemia Leukocytes (neutrophilic) Lymphoma Medicine Medicine & Public Health Methotrexate Methotrexate - administration & dosage Mucositis Oncology Original Article Prophylaxis Recurrence Retrospective Studies Survival Rate Tacrolimus Tacrolimus - administration & dosage Transplantation Treatment Outcome |
| title | GVHD prophylaxis by tacrolimus and mini-MTX in single-unit CBT: a single institute experience |
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