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Graft-Versus-Host Disease

Cyclosporin A and mini short-term methotrexate vs cyclosporin A as graft-versus-host disease prophylaxis in patients with beta thalassemia major undergoing allogeneic blood and marrow transplantation

Bone Marrow Transplantation volume 35, pages 1095–1099 (2005)Cite this article

Summary:

We compared the effects of cyclosporin A (CsA) alone as graft-versus-host disease (GVHD) prophylaxis vs cyclosporine with short-course methotrexate (MTX) in patients with thalassemia. In all, 140 patients were enrolled in this study. The first group, of 50 patients, received CsA alone at 3 mg/kg i.v. from day −2 to +5 followed by 12.5 mg/kg p.o., which was tapered according to the patient's condition. The other group, of 90 patients, received the combination of CsA+MTX in which CsA was used with the above-mentioned dose and MTX was on 10 mg/m2 day +1 and 6 mg/m2 on days +3 and +6. Incidence of acute GVHD grade II–IV in the CsA group was 78% and in the CsA+MTX group was 52.2%, which was statistically significant (P=<0.001). There were no significant differences in the incidence of chronic GVHD between the two groups. The mean neutrophil engraftment to 0.5 × 109/l was 14 and 23 days for CsA group and CsA+MTX group, respectively (P=<0.001). There were no significant differences for platelet recovery between the two groups. Graft failure in the CsA and CsA+MTX groups was seven (14%) and nine (10%) patients, respectively (P=0.58). Overall survival in the CsA and CsA+MTX groups was 77 and 85%, respectively. Disease-free survival in the CsA and CsA+MTX groups were 58 and 80%, respectively.

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Authors and Affiliations

  1. Hematology-Oncology & BMT Research Center, Tehran University of Medical, Sciences, Tehran, Iran

    M Iravani, A Mousavi, S Gholibeikian, B Bahar, S Samiee, A Ashouri, L Eghbal & A Ghavamzadeh

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  1. M Iravani
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Correspondence to M Iravani.

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Iravani, M., Mousavi, A., Gholibeikian, S. et al. Cyclosporin A and mini short-term methotrexate vs cyclosporin A as graft-versus-host disease prophylaxis in patients with beta thalassemia major undergoing allogeneic blood and marrow transplantation. Bone Marrow Transplant 35, 1095–1099 (2005). https://doi.org/10.1038/sj.bmt.1704935

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