title: Efficacy of folinic acid in preventing oral mucositis in allogeneic hematopoietic stem cell transplant patients receiving MTX as prophylaxis for GVHD.
abstract: As the safety of folinic acid administration and its efficacy for reducing the toxicity of MTX remain controversial, we assessed the effect of folinic acid administration after MTX treatment for GVHD prophylaxis on the incidence of oral mucositis and acute GVHD. We retrospectively analyzed data for 118 patients who had undergone allogeneic hematopoietic SCT and had received MTX for GVHD prophylaxis. Multivariate analysis showed that systemic folinic acid administration significantly reduced the incidence of severe oral mucositis (odds ratio (OR)=0.13, 95% confidence interval (CI) 0.04-0.73, P=0.014). There was also a tendency for a lower incidence of severe oral mucositis in patients who received folinic acid mouthwash (OR=0.39, 95%CI 0.15-1.00, P=0.051). No significant difference was observed in the incidence of acute GVHD between patients who received systemic folinic acid administration and those who did not (P=0.88). Systemic folinic acid administration and mouthwash appear to be useful for reducing the incidence of severe oral mucositis in patients who have received allogeneic hematopoietic SCT using MTX as GVHD prophylaxis.
authors.affiliation: Stem Cell Transplantation Center, Hokkaido University Hospital, Sapporo, Japan. sugitaj@med.hokudai.ac.jp
authors.forename: J
authors.initials: J
authors.lastname: Sugita
authors.forename: T
authors.initials: T
authors.lastname: Matsushita
authors.forename: H
authors.initials: H
authors.lastname: Kashiwazaki
authors.forename: M
authors.initials: M
authors.lastname: Kosugi
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.forename: K
authors.initials: K
authors.lastname: Wakasa
authors.forename: S
authors.initials: S
authors.lastname: Shiratori
authors.forename: M
authors.initials: M
authors.lastname: Ibata
authors.forename: Y
authors.initials: Y
authors.lastname: Shono
authors.forename: A
authors.initials: A
authors.lastname: Shigematsu
authors.forename: M
authors.initials: M
authors.lastname: Obara
authors.forename: K
authors.initials: K
authors.lastname: Fujimoto
authors.forename: T
authors.initials: T
authors.lastname: Endo
authors.forename: M
authors.initials: M
authors.lastname: Nishio
authors.forename: T
authors.initials: T
authors.lastname: Kondo
authors.forename: S
authors.initials: S
authors.lastname: Hashino
authors.forename: J
authors.initials: J
authors.lastname: Tanaka
authors.forename: M
authors.initials: M
authors.lastname: Asaka
authors.forename: M
authors.initials: M
authors.lastname: Imamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000517:prevention & control*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D002955:Leucovorin / Q000627:therapeutic use*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D013280:Stomatitis / Q000188:drug therapy / Q000517:prevention & control*; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D002955:Leucovorin; D008727:Methotrexate