title: Low-dose MTX combined with low-dose methylprednisolone as a first-line therapy for the treatment of acute GVHD: safety and feasibility.
abstract: To study the efficacy and safety of a low dose of MTX combined with a low dose of methylprednisolone (MP) as a first-line therapy in the treatment of acute GVHD (aGVHD) after allogeneic hematopoietic SCT, 32 patients received i.v. MTX at a dose of 10 mg or oral MTX at a dose of 15 mg every 3-7 days (repeated at day 3 after the first dose and then at a weekly interval) combined with a low dose of MP (0.5 mg/kg/day) until a complete or partial response was achieved, or until treatment failure or intolerable side effects occurred. The overall treatment response rate was 81% (26/32 patients) and the response rate at day 28 was 75% (24/32 patients). The response rate for GVHD involving various organs was 88% (23/26) in the skin, 75% (3/4) in the liver and 81% (9/11) in the gut. Grade 3 toxicities occurred in only three patients presenting cytopenias. The estimated survival at 2 years was 77%. From this analysis, MTX in combination with a low dose of MP appears to be a well-tolerated, effective and inexpensive regime when used as a first-line treatment for aGVHD.
authors: Institute of Hematology, Peking University People's Hospital, Beijing, China.
authors: Y
authors: Y
authors: Wang
authors: L P
authors: LP
authors: Xu
authors: K Y
authors: KY
authors: Liu
authors: D H
authors: DH
authors: Liu
authors: J
authors: J
authors: Wang
authors: H
authors: H
authors: Chen
authors: Y H
authors: YH
authors: Chen
authors: W
authors: W
authors: Han
authors: X J
authors: XJ
authors: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents; D000964:Antimetabolites, Antineoplastic; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000964:Antimetabolites, Antineoplastic; D008775:Methylprednisolone; D008727:Methotrexate