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

19 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
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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