Low-dose methotrexate may preserve a stronger antileukemic effect than that of cyclosporine after modified donor lymphocyte infusion in unmanipulated haploidentical HSCT
© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd..
To compare the impacts of low-dose methotrexate (MTX) with cyclosporine (CSA) on graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL) effect after haploidentical modified donor lymphocyte infusion (DLI). Fifty-five consecutive patients who had relapsed acute leukemia after haploidentical hematopoietic stem cell transplantation (HSCT) and received modified DLI were retrospectively studied. Forty-one patients received CSA and 14 received low-dose MTX after DLI to prevent DLI-associated GVHD. The incidence of acute GVHD and grade 2-4 acute GVHD in MTX group showed a trend toward being higher than in CSA group (61.0% vs. 37.3%, p = 0.198 and 61.0% vs. 35.5%, p = 0.155). However, no significant difference in the incidence of grade 3-4 acute GVHD between two groups (p = 0.982) was observed. Moreover, compared with CSA, patients treated with MTX had lower re-relapse rate (38.1% vs. 80.8%, p = 0.029), better disease-free survival (DFS) (51.9% vs. 15.6%, p = 0.06), and higher absolute lymphocyte counts at 30, 45, 60, and 90 d after modified DLI (p < 0.05). This study suggested that after haploidentical modified DLI, low-dose MTX is at least as effective as CSA in the prevention of DLI-associated GVHD and probably allowed stronger GVL effect than CSA. This phenomenon was probably due to a direct antitumor effect and a better reconstitution of lymphocytes after modified DLI induced by low-dose MTX.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Clinical transplantation - 29(2015), 7 vom: 27. Juli, Seite 594-605 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Yan, Chen-Hua [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 05.05.2016 Date Revised 20.07.2015 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/ctr.12561 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM248970682 |
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| 245 | 1 | 0 | |a Low-dose methotrexate may preserve a stronger antileukemic effect than that of cyclosporine after modified donor lymphocyte infusion in unmanipulated haploidentical HSCT |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. | ||
| 520 | |a To compare the impacts of low-dose methotrexate (MTX) with cyclosporine (CSA) on graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL) effect after haploidentical modified donor lymphocyte infusion (DLI). Fifty-five consecutive patients who had relapsed acute leukemia after haploidentical hematopoietic stem cell transplantation (HSCT) and received modified DLI were retrospectively studied. Forty-one patients received CSA and 14 received low-dose MTX after DLI to prevent DLI-associated GVHD. The incidence of acute GVHD and grade 2-4 acute GVHD in MTX group showed a trend toward being higher than in CSA group (61.0% vs. 37.3%, p = 0.198 and 61.0% vs. 35.5%, p = 0.155). However, no significant difference in the incidence of grade 3-4 acute GVHD between two groups (p = 0.982) was observed. Moreover, compared with CSA, patients treated with MTX had lower re-relapse rate (38.1% vs. 80.8%, p = 0.029), better disease-free survival (DFS) (51.9% vs. 15.6%, p = 0.06), and higher absolute lymphocyte counts at 30, 45, 60, and 90 d after modified DLI (p < 0.05). This study suggested that after haploidentical modified DLI, low-dose MTX is at least as effective as CSA in the prevention of DLI-associated GVHD and probably allowed stronger GVL effect than CSA. This phenomenon was probably due to a direct antitumor effect and a better reconstitution of lymphocytes after modified DLI induced by low-dose MTX | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a cyclosporine | |
| 650 | 4 | |a graft-versus-host disease | |
| 650 | 4 | |a graft-versus-leukemia effect | |
| 650 | 4 | |a haploidentical hematopoietic stem cell transplantation | |
| 650 | 4 | |a methotrexate | |
| 650 | 4 | |a modified donor lymphocyte infusion | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
| 650 | 7 | |a Cyclosporine |2 NLM | |
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| 650 | 7 | |a Methotrexate |2 NLM | |
| 650 | 7 | |a YL5FZ2Y5U1 |2 NLM | |
| 700 | 1 | |a Xu, Lan-Ping |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Dai-hong |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Huan |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Jing-zhi |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Feng-rong |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Kai-Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Xiao-Jun |e verfasserin |4 aut | |
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