PMID- 36372357
OWN - NLM
STAT- MEDLINE
DCOM- 20230213
LR  - 20230424
IS  - 2666-6367 (Electronic)
IS  - 2666-6367 (Linking)
VI  - 29
IP  - 2
DP  - 2023 Feb
TI  - Significance of Omitting Day 11 Mini-Dose Methotrexate for GVHD Prophylaxis After 
      Unrelated Bone Marrow Transplantation.
PG  - 119.e1-119.e7
LID - S2666-6367(22)01771-7 [pii]
LID - 10.1016/j.jtct.2022.11.006 [doi]
AB  - The combination of calcineurin inhibitors and short-term methotrexate has been 
      used as a standard graft-versus-host-disease (GVHD) prophylaxis in allogeneic 
      hematopoietic stem cell transplantation. Mini-dose methotrexate (mini-MTX), 
      consisting of 5 mg/m(2)/d on days 1, 3, 6, and 11, is occasionally selected as an 
      alternative considering toxicity. The significance of day 11 administration 
      remains unclear. We performed a retrospective study of 135 cases of unrelated 
      bone marrow transplantation at our institute between 2006 and 2019 and compared 
      the outcomes between day 11 MTX dose omitted (n = 72) and full-doses of mini-MTX 
      (n = 63). In total cohort, the 4-year overall survival (OS) was 58.7 %, and the 
      omitted group showed poor GVHD/relapse-free-survival (P = .01) with comparable OS 
      (P = .11) and relapse-free survival (P = .11). Human leukocyte antigen (HLA) 
      mismatch is a major risk factor for severe GVHD. We analyzed the impact of 
      omitting day 11 MTX in 2 cohorts from HLA matched or mismatched donors. In both 
      cohorts, the omitted group had a higher risk of severe acute and chronic GVHD. In 
      conclusion, the omission of day 11 MTX was associated with a higher risk of 
      severe GVHD. Therefore the omission of the day 11 dose is not recommended.
CI  - Copyright (c) 2022 The American Society for Transplantation and Cellular Therapy. 
      Published by Elsevier Inc. All rights reserved.
FAU - Nakamura, Naokazu
AU  - Nakamura N
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
FAU - Wada, Fumiya
AU  - Wada F
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
FAU - Kondo, Tadakazu
AU  - Kondo T
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan; Department of Hematology, Kobe City Medical Center 
      General Hospital, Kobe, Japan. Electronic address: tadakazu@kuhp.kyoto-u.ac.jp.
FAU - Aoki, Kazunari
AU  - Aoki K
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan; Stem Cell Genetics, Institute for Life and Medical 
      Sciences, Kyoto University, Kyoto, Japan.
FAU - Arai, Yasuyuki
AU  - Arai Y
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan; Department of Clinical Laboratory Medicine, Faculty of 
      Medicine, Kyoto University, Kyoto, Japan.
FAU - Mizumoto, Chisaki
AU  - Mizumoto C
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
FAU - Kanda, Junya
AU  - Kanda J
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
FAU - Kitawaki, Toshio
AU  - Kitawaki T
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
FAU - Yamashita, Kouhei
AU  - Yamashita K
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
FAU - Takaori-Kondo, Akifumi
AU  - Takaori-Kondo A
AD  - Department of Hematology and Oncology, Graduate School of Medicine, Kyoto 
      University, Kyoto, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221111
PL  - United States
TA  - Transplant Cell Ther
JT  - Transplantation and cellular therapy
JID - 101774629
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Humans
MH  - *Methotrexate/therapeutic use
MH  - Bone Marrow Transplantation/adverse effects
MH  - Retrospective Studies
MH  - Transplantation, Homologous/adverse effects
MH  - *Graft vs Host Disease/etiology/prevention & control
OTO - NOTNLM
OT  - GVHD
OT  - Methotrexate
OT  - Prophylaxis
OT  - Unrelated bone marrow transplantation
EDAT- 2022/11/14 06:00
MHDA- 2023/02/14 06:00
CRDT- 2022/11/13 19:35
PHST- 2022/08/20 00:00 [received]
PHST- 2022/10/12 00:00 [revised]
PHST- 2022/11/03 00:00 [accepted]
PHST- 2022/11/14 06:00 [pubmed]
PHST- 2023/02/14 06:00 [medline]
PHST- 2022/11/13 19:35 [entrez]
AID - S2666-6367(22)01771-7 [pii]
AID - 10.1016/j.jtct.2022.11.006 [doi]
PST - ppublish
SO  - Transplant Cell Ther. 2023 Feb;29(2):119.e1-119.e7. doi: 
      10.1016/j.jtct.2022.11.006. Epub 2022 Nov 11.