Low-dose methotrexate for the treatment of graft-versus-host disease after allogeneic hematopoietic stem cell transplantation.
Methotrexate (MTX) is commonly used in the prophylaxis of graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In order to evaluate the efficacy and safety of low-dose MTX treatment in patients with GVHD after allo-HSCT, 38 patients with acute GVHD (aGVHD), chronic GVHD (cGVHD) or GVHD post-donor lymphocyte infusion (post-DLI GVHD) after allo-HSCT received intravenous MTX at a dose of 5 or 10 mg every 5-- days until a complete or partial response was seen, or there was treatment failure or intolerable side effects. The overall response rate was 94.7% (18/19 patients) in patients with aGVHD, 76.2% (16/21 patients) in patients with cGVHD and 2/2 in patients with post-DLI GVHD. The response rate for GVHD involving various organs was 100% in skin, 75% in gut, 55.6% in liver, 75% in mouth and 100% in the eye, among all enrolled patients. Side effects were minor. Short-term, low-dose MTX is a tolerable and an effective regimen for patients with aGVHD, cGVHD or post-DLI GVHD after allo-HSCT.
Huang
X-J
XJ
Institute of Hematology, Peking University, People'Hospital, Beijing, China. xjhrm@medmail.com.cn
Jiang
Q
Q
Chen
H
H
Xu
L
L
Liu
D
D
Chen
Y
Y
Han
W
W
Zhang
Y
Y
Liu
K
K
Lu
D
D
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D017710:Lymphocyte Transfusion; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage* / Q000633:toxicity; D008875:Middle Aged; D011292:Premedication; D016896:Treatment Outcome
D008727:Methotrexate