التفاصيل البيبلوغرافية
| العنوان: |
Short-term methotrexate could reduce early immune reactions and improve outcomes in umbilical cord blood transplantation for adults. |
| المؤلفون: |
Narimatsu, H., Terakura, S., Matsuo, K., Oba, T., Uchida, T., Iida, H., Hamaguchi, M., Watanabe, M., Kohno, A., Murata, M., Sawa, M., Miyamura, K., Morishita, Y. |
| المصدر: |
Bone Marrow Transplantation; Jan2007, Vol. 39 Issue 1, p31-39, 9p, 5 Charts, 3 Graphs |
| مصطلحات موضوعية: |
CORD blood, TRANSPLANTATION of organs, tissues, etc., PATIENTS, PREVENTIVE medicine, GRAFT versus host disease, METHOTREXATE |
| مستخلص: |
Post transplant immune disorders are problematic in cord blood transplantation (CBT) for adult patients, and optimal prophylaxis has not been established. We investigated whether intensive graft-versus-host disease (GVHD) prophylaxis using short-term methotrexate (MTX) has a prognostic impact on CBT. Post-CBT immune reactions were classified according to time course as pre-engraftment immune reaction (PIR), engraftment syndrome (ES) or acute GVHD. Between March 2001 and November 2005, a total of 77 patients underwent CBT at eight transplantation centers. Median age was 48 years (range, 18–69 years). Preparative regimens comprised myeloablative (n=31) or reduced-intensity (n=46). Acute GVHD prophylaxis included cyclosporine alone (n=23), tacrolimus alone (n=12), cyclosporine plus MTX (n=17), tacrolimus plus short-term MTX (n=23) or cyclosporine plus methylprednisolone (n=2). Cumulative incidences of PIR, ES and grade II–IV GVHD were 36, 12 and 23%, respectively. Short-term MTX exerted significant favorable effects on post-CBT immune reactions (hazard ratio, 0.55; 95% confidence interval (95% CI), 0.31–0.98; P=0.04) in multivariate analysis. Overall survival rates for patients with and without short-term MTX at day 180 were 59% (95% CI, 42–73%) and 16% (95% CI, 6.6–30%) (P=0.0001), respectively. Short-term MTX could offer one optimal regimen to reduce immune reactions and improve outcomes in CBT.Bone Marrow Transplantation (2007) 39, 31–39. doi:10.1038/sj.bmt.1705539; published online 20 November 2006 [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
