Tacrolimus/Methotrexate versus Cyclosporine/Methotrexate as Graft-versus-Host Disease Prophylaxis in Patients with Severe Aplastic Anemia Who Received Bone Marrow Transplantation from Unrelated Donors: Results of Matched Pair Analysis

Hiroshi Yagasaki, Seiji Kojima, Hiromasa Yabe, Koji Kato, Hisato Kigasawa, Hisashi Sakamaki, Masahiro Tsuchida, Shunichi Kato, Takakaza Kawase, Hideki Muramatsu, Yasuo Morishima, Yoshihisa Kodera

    Research output: Contribution to journalArticle

    18 Citations (Scopus)

    Abstract

    Tacrolimus (FK) and cyclosporine (CsA) have been shown to be effective in the prophylaxis of graft-versus-host disease (GVHD). However, no comparative studies have yet been conducted to examine the efficacy of FK/methotrexate (MTX) and CsA/MTX in patients with severe aplastic anemia (SAA) given unrelated donor bone marrow transplantation (U-BMT). We used matched-pair analysis to compare FK/MTX with CsA/MTX in patients with SAA who received U-BMT through the Japan Marrow Donor Program. Forty-seven pairs could be matched exactly for recipient age and conditioning regimens. Forty-five patients achieved engraftment in the FK group and 42 patients in the CsA group. The probability of grade II-IV acute GVHD (aGVHD) was 28.9% in the FK group and 32.6% in the CsA group (P = .558). The probability of chronic GVHD (cGVHD) was 13.3% in the FK group and 36.0% in the CsA group (P = .104). The 5-year survival rate was 82.8% in the FK group and 49.5% in the CsA group (P = .012). The study shows the superiority of FK/MTX over CsA/MTX in overall survival because of the lower incidence of transplantation-related deaths. A prospective randomized study comparing FK/MTX and CsA/MTX is warranted.

    Original languageEnglish
    Pages (from-to)1603-1608
    Number of pages6
    JournalBiology of Blood and Marrow Transplantation
    Volume15
    Issue number12
    DOIs
    Publication statusPublished - Dec 1 2009

    Fingerprint

    Matched-Pair Analysis
    Unrelated Donors
    Aplastic Anemia
    Tacrolimus
    Graft vs Host Disease
    Bone Marrow Transplantation
    Methotrexate
    Cyclosporine
    Japan
    Survival Rate
    Transplantation
    Bone Marrow
    Tissue Donors
    Prospective Studies
    Survival
    Incidence

    All Science Journal Classification (ASJC) codes

    • Hematology
    • Transplantation

    Cite this

    Tacrolimus/Methotrexate versus Cyclosporine/Methotrexate as Graft-versus-Host Disease Prophylaxis in Patients with Severe Aplastic Anemia Who Received Bone Marrow Transplantation from Unrelated Donors : Results of Matched Pair Analysis. / Yagasaki, Hiroshi; Kojima, Seiji; Yabe, Hiromasa; Kato, Koji; Kigasawa, Hisato; Sakamaki, Hisashi; Tsuchida, Masahiro; Kato, Shunichi; Kawase, Takakaza; Muramatsu, Hideki; Morishima, Yasuo; Kodera, Yoshihisa.

    In: Biology of Blood and Marrow Transplantation, Vol. 15, No. 12, 01.12.2009, p. 1603-1608.

    Research output: Contribution to journalArticle

    Yagasaki, Hiroshi ; Kojima, Seiji ; Yabe, Hiromasa ; Kato, Koji ; Kigasawa, Hisato ; Sakamaki, Hisashi ; Tsuchida, Masahiro ; Kato, Shunichi ; Kawase, Takakaza ; Muramatsu, Hideki ; Morishima, Yasuo ; Kodera, Yoshihisa. / Tacrolimus/Methotrexate versus Cyclosporine/Methotrexate as Graft-versus-Host Disease Prophylaxis in Patients with Severe Aplastic Anemia Who Received Bone Marrow Transplantation from Unrelated Donors : Results of Matched Pair Analysis. In: Biology of Blood and Marrow Transplantation. 2009 ; Vol. 15, No. 12. pp. 1603-1608.
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    abstract = "Tacrolimus (FK) and cyclosporine (CsA) have been shown to be effective in the prophylaxis of graft-versus-host disease (GVHD). However, no comparative studies have yet been conducted to examine the efficacy of FK/methotrexate (MTX) and CsA/MTX in patients with severe aplastic anemia (SAA) given unrelated donor bone marrow transplantation (U-BMT). We used matched-pair analysis to compare FK/MTX with CsA/MTX in patients with SAA who received U-BMT through the Japan Marrow Donor Program. Forty-seven pairs could be matched exactly for recipient age and conditioning regimens. Forty-five patients achieved engraftment in the FK group and 42 patients in the CsA group. The probability of grade II-IV acute GVHD (aGVHD) was 28.9{\%} in the FK group and 32.6{\%} in the CsA group (P = .558). The probability of chronic GVHD (cGVHD) was 13.3{\%} in the FK group and 36.0{\%} in the CsA group (P = .104). The 5-year survival rate was 82.8{\%} in the FK group and 49.5{\%} in the CsA group (P = .012). The study shows the superiority of FK/MTX over CsA/MTX in overall survival because of the lower incidence of transplantation-related deaths. A prospective randomized study comparing FK/MTX and CsA/MTX is warranted.",
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    AU - Yagasaki, Hiroshi

    AU - Kojima, Seiji

    AU - Yabe, Hiromasa

    AU - Kato, Koji

    AU - Kigasawa, Hisato

    AU - Sakamaki, Hisashi

    AU - Tsuchida, Masahiro

    AU - Kato, Shunichi

    AU - Kawase, Takakaza

    AU - Muramatsu, Hideki

    AU - Morishima, Yasuo

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