title: Tailoring the GVHD prophylaxis regimen according to transplantation associated toxicities-Substituting the 3rd dose of methotrexate to mycophenolate mofetil.
abstract: We hypothesized that in patients with early post allogeneic transplantation toxicities, the omission of the 3rd dose of methotrexate with concomitant starting of MMF would favorably affect complications. We found a higher incidence of grade 2-4 acute GVHD in patients given two doses methotrexate and MMF (n=31) compared to those given three courses of methotrexate (n=70) (p=.004), while grade 3-4 was similar. Other transplantation outcomes, including overall regimen-related-toxicity, were comparable. We conclude that tailoring the GVHD prophylaxis regimen may decrease the early post transplantation complications, however this come at the extent of a higher incidence of non-severe acute GVHD.
authors.affiliation: BMT Unit, Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqva, Israel; Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel. Electronic address: ronram73@gmail.com.
authors.forename: Ron
authors.initials: R
authors.lastname: Ram
authors.affiliation: BMT Unit, Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqva, Israel; Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: Corina
authors.initials: C
authors.lastname: Herscovici
authors.affiliation: Public Health Services Israel Ministry of Health, Israel.
authors.forename: Dikla
authors.initials: D
authors.lastname: Dahan
authors.affiliation: Tissue Typing Laboratory, Rabin Medical Center, Petah-Tiqva, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Israeli
authors.affiliation: BMT Unit, Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqva, Israel.
authors.forename: Juliet
authors.initials: J
authors.lastname: Dreyer
authors.affiliation: BMT Unit, Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqva, Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Peck
authors.affiliation: BMT Unit, Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqva, Israel; Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Shpilberg
authors.affiliation: BMT Unit, Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqva, Israel; Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Yeshurun
mesh_terms: D000328:Adult; D000368:Aged; D004334:Drug Administration Schedule; D057915:Drug Substitution; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007938:Leukemia / Q000453:epidemiology / Q000628:therapy; D008223:Lymphoma / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D008727:Methotrexate
keywords: GVHD; Hematopoietic cell transplantation; MMF; Methotrexate