title: Folinic acid after MTX as prophylaxis for GVHD in pediatric bone marrow transplantation.
abstract: The effect of folinic acid (FA) on toxicity secondary to the use of methotrexate (MTX) for the prevention of graft-versus-host disease (GVHD) has not been determined. We retrospectively analyzed data from 111 patients who received allogeneic bone marrow transplantation (allo-BMT) in our institution. Fifty patients did not receive FA (non-FA), 37 received FA four times (low dose, LD-FA), and 24 received FA 25 times (high dose, HD-FA) in BMT. No significant differences were observed in the severity of stomatitis after allo-BMT among the three groups while the median of peak value of ALT in HD-FA was significantly lower (P = 0.031). The median time to neutrophil engraftment after allo-BMT in the HD-FA group was significantly shorter than that in the non-FA group (P = 0.034). No significant difference in the median time to neutrophil engraftment was observed between the LD-FA and non-FA groups (P = 0.44). Stepwise multiple regression analysis revealed that the determinants of the shorter duration of neutropenia were transfused total nucleated cell dose (P = 0.001) and the administration of HD-FA (P = 0.036). There was no significant difference in 3-year overall survival among the three groups. Frequent administration of FA may reduce the time to neutrophil engraftment after hematopoietic stem cell transplantation.
authors.affiliation: Department of Pediatrics, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kodama
authors.forename: Reiji
authors.initials: R
authors.lastname: Fukano
authors.forename: Maiko
authors.initials: M
authors.lastname: Noguchi
authors.forename: Jun
authors.initials: J
authors.lastname: Okamura
authors.forename: Jiro
authors.initials: J
authors.lastname: Inagaki
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D063868:Patient Outcome Assessment; D011292:Premedication; D012189:Retrospective Studies; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D002955:Leucovorin; D008727:Methotrexate