Safety and potential efficacy of low-dose methotrexate for treatment of chronic graft-versus-host disease
Low-dose methotrexate (MTX) is widely used in autoimmune diseases because of its anti-inflammatory activity. We report here the results of a retrospective study to review the outcomes of low-dose MTX used for treatment of refractory chronic graft-versus-host disease GVHD, with the goal of reducing t...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2005-08, Vol.36 (4), p.337-341 |
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| creator | Giaccone, L Martin, P Carpenter, P Moravec, C Hooper, H Funke, V A M Storb, R Flowers, M E D |
| description | Low-dose methotrexate (MTX) is widely used in autoimmune diseases because of its anti-inflammatory activity. We report here the results of a retrospective study to review the outcomes of low-dose MTX used for treatment of refractory chronic graft-versus-host disease GVHD, with the goal of reducing the amount of prednisone needed to control the disease. In all, 14 patients with refractory chronic GVHD received MTX at a dose of 7.5 mg/m
2
/weekly for 3–50 weeks. Also, 11 patients had skin involvement, often with scleroderma or fasciitis. The median duration of chronic GVHD at the start of MTX was 38 (range 1–135) months. In this retrospective review, we found no grade 3–4 toxicities, and none of the patients needed blood transfusion or growth factors. In 10 patients (71%), GVHD could be adequately controlled with prednisone at doses below 1 mg/kg every other day without the addition of other agents. Four patients decreased the amount of concomitant immunosuppressive treatment, five continued with the same regimen, four required an increase in immunosuppressive treatment, and one decided to discontinue all treatment. From this preliminary analysis, MTX appears to be a well-tolerated, inexpensive and possibly steroid-sparing agent that is worthy of further evaluation in prospective trials for treatment of chronic GVHD. |
| doi_str_mv | 10.1038/sj.bmt.1705022 |
| format | Article |
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From this preliminary analysis, MTX appears to be a well-tolerated, inexpensive and possibly steroid-sparing agent that is worthy of further evaluation in prospective trials for treatment of chronic GVHD.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/sj.bmt.1705022</identifier><identifier>PMID: 15968296</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anti-inflammatory agents ; Autoimmune diseases ; Biological and medical sciences ; Blood transfusion ; Bone marrow ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Cell Biology ; Chronic Disease ; Clinical trials ; Complications and side effects ; Diagnosis ; Disease control ; Dosage and administration ; Drug Evaluation ; Drug therapy ; Drug Therapy, Combination ; Fasciitis ; Female ; Graft versus host disease ; Graft versus host reaction ; Graft vs Host Disease - drug therapy ; Graft vs Host Disease - pathology ; Growth factors ; Health services ; Hematology ; Hematopoietic Stem Cell Transplantation - adverse effects ; Hematopoietic stem cells ; Humans ; Inflammation ; Internal Medicine ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Methotrexate ; Methotrexate - administration & dosage ; Methotrexate - toxicity ; Middle Aged ; original-article ; Patient outcomes ; Patients ; Prednisone ; Prednisone - administration & dosage ; Public Health ; Reagents ; Retrospective Studies ; Risk factors ; Salvage Therapy ; Scleroderma ; Stem cell transplantation ; Stem Cells ; Toxicity ; Transfusion ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; Treatment Outcome</subject><ispartof>Bone marrow transplantation (Basingstoke), 2005-08, Vol.36 (4), p.337-341</ispartof><rights>Springer Nature Limited 2005</rights><rights>2005 INIST-CNRS</rights><rights>Bone Marrow Transplantation (2005) 36, 337-341.</rights><rights>COPYRIGHT 2005 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Aug 2005</rights><rights>Nature Publishing Group 2005.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c604t-b7b88bb383374499a959dde45fb25af13b8b3af683b99a400cf09c455d1aa6d53</citedby><cites>FETCH-LOGICAL-c604t-b7b88bb383374499a959dde45fb25af13b8b3af683b99a400cf09c455d1aa6d53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/sj.bmt.1705022$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/sj.bmt.1705022$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,2725,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17016607$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15968296$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giaccone, L</creatorcontrib><creatorcontrib>Martin, P</creatorcontrib><creatorcontrib>Carpenter, P</creatorcontrib><creatorcontrib>Moravec, C</creatorcontrib><creatorcontrib>Hooper, H</creatorcontrib><creatorcontrib>Funke, V A M</creatorcontrib><creatorcontrib>Storb, R</creatorcontrib><creatorcontrib>Flowers, M E D</creatorcontrib><title>Safety and potential efficacy of low-dose methotrexate for treatment of chronic graft-versus-host disease</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><addtitle>Bone Marrow Transplant</addtitle><description>Low-dose methotrexate (MTX) is widely used in autoimmune diseases because of its anti-inflammatory activity. We report here the results of a retrospective study to review the outcomes of low-dose MTX used for treatment of refractory chronic graft-versus-host disease GVHD, with the goal of reducing the amount of prednisone needed to control the disease. In all, 14 patients with refractory chronic GVHD received MTX at a dose of 7.5 mg/m
2
/weekly for 3–50 weeks. Also, 11 patients had skin involvement, often with scleroderma or fasciitis. The median duration of chronic GVHD at the start of MTX was 38 (range 1–135) months. In this retrospective review, we found no grade 3–4 toxicities, and none of the patients needed blood transfusion or growth factors. In 10 patients (71%), GVHD could be adequately controlled with prednisone at doses below 1 mg/kg every other day without the addition of other agents. Four patients decreased the amount of concomitant immunosuppressive treatment, five continued with the same regimen, four required an increase in immunosuppressive treatment, and one decided to discontinue all treatment. From this preliminary analysis, MTX appears to be a well-tolerated, inexpensive and possibly steroid-sparing agent that is worthy of further evaluation in prospective trials for treatment of chronic GVHD.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anti-inflammatory agents</subject><subject>Autoimmune diseases</subject><subject>Biological and medical sciences</subject><subject>Blood transfusion</subject><subject>Bone marrow</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Cell Biology</subject><subject>Chronic Disease</subject><subject>Clinical trials</subject><subject>Complications and side effects</subject><subject>Diagnosis</subject><subject>Disease control</subject><subject>Dosage and administration</subject><subject>Drug Evaluation</subject><subject>Drug therapy</subject><subject>Drug Therapy, Combination</subject><subject>Fasciitis</subject><subject>Female</subject><subject>Graft versus host disease</subject><subject>Graft versus host reaction</subject><subject>Graft vs Host Disease - drug therapy</subject><subject>Graft vs Host Disease - pathology</subject><subject>Growth factors</subject><subject>Health services</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Hematopoietic stem cells</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methotrexate</subject><subject>Methotrexate - administration & dosage</subject><subject>Methotrexate - toxicity</subject><subject>Middle Aged</subject><subject>original-article</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Prednisone</subject><subject>Prednisone - administration & dosage</subject><subject>Public Health</subject><subject>Reagents</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Salvage Therapy</subject><subject>Scleroderma</subject><subject>Stem cell transplantation</subject><subject>Stem Cells</subject><subject>Toxicity</subject><subject>Transfusion</subject><subject>Transfusions. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anti-inflammatory agents</topic><topic>Autoimmune diseases</topic><topic>Biological and medical sciences</topic><topic>Blood transfusion</topic><topic>Bone marrow</topic><topic>Bone marrow, stem cells transplantation. Graft versus host reaction</topic><topic>Cell Biology</topic><topic>Chronic Disease</topic><topic>Clinical trials</topic><topic>Complications and side effects</topic><topic>Diagnosis</topic><topic>Disease control</topic><topic>Dosage and administration</topic><topic>Drug Evaluation</topic><topic>Drug therapy</topic><topic>Drug Therapy, Combination</topic><topic>Fasciitis</topic><topic>Female</topic><topic>Graft versus host disease</topic><topic>Graft versus host reaction</topic><topic>Graft vs Host Disease - drug therapy</topic><topic>Graft vs Host Disease - pathology</topic><topic>Growth factors</topic><topic>Health services</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation - adverse effects</topic><topic>Hematopoietic stem cells</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Methotrexate</topic><topic>Methotrexate - administration & dosage</topic><topic>Methotrexate - toxicity</topic><topic>Middle Aged</topic><topic>original-article</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Prednisone</topic><topic>Prednisone - administration & dosage</topic><topic>Public Health</topic><topic>Reagents</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Salvage Therapy</topic><topic>Scleroderma</topic><topic>Stem cell transplantation</topic><topic>Stem Cells</topic><topic>Toxicity</topic><topic>Transfusion</topic><topic>Transfusions. 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We report here the results of a retrospective study to review the outcomes of low-dose MTX used for treatment of refractory chronic graft-versus-host disease GVHD, with the goal of reducing the amount of prednisone needed to control the disease. In all, 14 patients with refractory chronic GVHD received MTX at a dose of 7.5 mg/m
2
/weekly for 3–50 weeks. Also, 11 patients had skin involvement, often with scleroderma or fasciitis. The median duration of chronic GVHD at the start of MTX was 38 (range 1–135) months. In this retrospective review, we found no grade 3–4 toxicities, and none of the patients needed blood transfusion or growth factors. In 10 patients (71%), GVHD could be adequately controlled with prednisone at doses below 1 mg/kg every other day without the addition of other agents. Four patients decreased the amount of concomitant immunosuppressive treatment, five continued with the same regimen, four required an increase in immunosuppressive treatment, and one decided to discontinue all treatment. From this preliminary analysis, MTX appears to be a well-tolerated, inexpensive and possibly steroid-sparing agent that is worthy of further evaluation in prospective trials for treatment of chronic GVHD.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>15968296</pmid><doi>10.1038/sj.bmt.1705022</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0268-3369 1476-5365 |
| language | eng |
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| source | MEDLINE; Nature Journals Online; EZB-FREE-00999 freely available EZB journals; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anti-inflammatory agents Autoimmune diseases Biological and medical sciences Blood transfusion Bone marrow Bone marrow, stem cells transplantation. Graft versus host reaction Cell Biology Chronic Disease Clinical trials Complications and side effects Diagnosis Disease control Dosage and administration Drug Evaluation Drug therapy Drug Therapy, Combination Fasciitis Female Graft versus host disease Graft versus host reaction Graft vs Host Disease - drug therapy Graft vs Host Disease - pathology Growth factors Health services Hematology Hematopoietic Stem Cell Transplantation - adverse effects Hematopoietic stem cells Humans Inflammation Internal Medicine Male Medical sciences Medicine Medicine & Public Health Methotrexate Methotrexate - administration & dosage Methotrexate - toxicity Middle Aged original-article Patient outcomes Patients Prednisone Prednisone - administration & dosage Public Health Reagents Retrospective Studies Risk factors Salvage Therapy Scleroderma Stem cell transplantation Stem Cells Toxicity Transfusion Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation Treatment Outcome |
| title | Safety and potential efficacy of low-dose methotrexate for treatment of chronic graft-versus-host disease |
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