A randomized study of the prevention of acute graft-versus-host disease.
Acute graft-versus-host disease is a major problem in allogeneic bone-marrow transplantation. We performed a randomized study to compare the effectiveness of two regimens in the prevention of acute graft-versus-host disease. Thirty-five patients received methotrexate alone, and 32 received methotrexate, antithymocyte globulin, and prednisone. Of the patients who received methotrexate alone, 48 per cent had acute graft-versus-host disease, as compared with 21 per cent of those who received methotrexate, antithymocyte globulin, and prednisone (P = 0.01). The age of the recipient was a significant factor in the development of acute graft-versus-host disease: Older patients had a higher incidence of the disease (P = 0.001). We conclude that the combination of methotrexate, antithymocyte globulin, and prednisone significantly decreased the incidence of acute graft-versus-host disease and should be used to prevent this disorder in patients receiving allogeneic marrow transplants.
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000494:pharmacology*; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D005260:Female; D006087:Graft vs Host Reaction / Q000187:drug effects*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000494:pharmacology*; D011241:Prednisone / Q000008:administration & dosage / Q000494:pharmacology*; D011897:Random Allocation; D013601:T-Lymphocytes
D000961:Antilymphocyte Serum; D011241:Prednisone; D008727:Methotrexate