Efficacy of folinic acid in preventing oral mucositis in allogeneic hematopoietic stem cell transplant patients receiving MTX as prophylaxis forGVHD
Efficacy of folinic acid in preventing oral mucositis in allogeneic hematopoietic stem cell transplant patients receiving MTX as prophylaxis forGVHD
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亚叶酸预防接受 MTX 预防 GVHD 的异基因造血干细胞移植患者口腔粘膜炎的功效
DOI：
10.1038/bmt.2011.53
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
Asaka M,Imamura M
中科院分区：
文献类型：
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作者：
Sugita J;Matsushita T;Kashiwazaki H;Kosugi M;Takahashi S;Wakasa K;Shiratori S;Ibata M;Shono Y;Shigematsu A;Obara M;Fujimoto K;Endo T;Nishio M;Kondo T;Hashino S;Tanaka J;Asaka M,Imamura M
由于甲氨蝶呤的安全性及其降低毒性的有效性仍存在争议，我们评估了甲氨蝶呤预防移植物抗宿主病后应用亚叶酸对口腔粘膜炎和急性移植物抗宿主病的影响。我们回顾分析了118名接受异基因造血干细胞移植并接受甲氨蝶呤预防移植物抗宿主病的患者的数据。多因素分析显示，全身应用亚叶酸可显著降低重度口腔粘膜炎的发生率(优势比OR=0.13，95%可信区间0.04~0.73，P=0.014)。使用亚叶酸含漱液的患者严重口腔粘膜炎的发生率也有降低的趋势(OR=0.39，95%CI0.15~1.00，P=0.051)。全身用药组与未用药组急性移植物抗宿主病的发生率差异无统计学意义(P=0.88)。在使用MTX预防移植物抗宿主病的异基因造血干细胞移植患者中，全身应用亚叶酸和漱口水似乎有助于降低严重口腔粘膜炎的发生率。
As the safety of folinic acid administration and its efficacy for reducing the toxicity of MTX remain controversial, we assessed the effect of folinic acid administration after MTX treatment for GVHD prophylaxis on the incidence of oral mucositis and acute GVHD. We retrospectively analyzed data for 118 patients who had undergone allogeneic hematopoietic SCT and had received MTX for GVHD prophylaxis. Multivariate analysis showed that systemic folinic acid administration significantly reduced the incidence of severe oral mucositis (odds ratio (OR)= 0.13, 95% confidence interval (CI) 0.04–0.73, P= 0.014). There was also a tendency for a lower incidence of severe oral mucositis in patients who received folinic acid mouthwash (OR= 0.39, 95% CI 0.15–1.00, P= 0.051). No significant difference was observed in the incidence of acute GVHD between patients who received systemic folinic acid administration and those who did not (P= 0.88). Systemic folinic acid administration and mouthwash appear to be useful for reducing the incidence of severe oral mucositis in patients who have received allogeneic hematopoietic SCT using MTX as GVHD prophylaxis.