Comparative analysis of graft-versus-host disease prophylaxis with tacrolimus in combination with methylprednisolone or methotrexate after umbilical cord blood transplantation
Comparative analysis of graft-versus-host disease prophylaxis with tacrolimus in combination with methylprednisolone or methotrexate after umbilical cord blood transplantation
复制标题
他克莫司联合甲泼尼龙或甲氨蝶呤预防脐带血移植后移植物抗宿主病的对比分析
DOI：
10.1007/s12185-020-02826-9
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发表时间：
2020
期刊：
影响因子：
2.1
通讯作者：
Nakazawa Y. Comparative analysis of graft-versus-host disease prophylaxis with tacrolimus in combination with methylprednisolone or methotrexa
中科院分区：
文献类型：
--
作者：
Shigemura T;Sakashita K;Okura E;Morita D;Komori K;Kurata T;Hirabayashi K;Saito S;Tanaka M;Yanagisawa R;Nakazawa Y. Comparative analysis of graft-versus-host disease prophylaxis with tacrolimus in combination with methylprednisolone or methotrexa
移植后早期免疫紊乱和移植失败/延迟是非亲缘脐带血移植（UCBT）的主要问题。我们在一个儿科移植中心通过比较他克莫司加甲泼尼龙（Tac/mPSL，n= 32）与Tac加甲氨蝶呤（Tac/MTX，n = 31）预防GVHD的UCBT结局，评价了UCBT后移植物抗宿主病（GVHD）的预防方法。Tac/mPSL和Tac/MTX组中性粒细胞植入的30天累积发生率和中位中性粒细胞植入时间分别为70.1%和90.3%以及19和17天（p= 0.09）。Tac/MTX可改善移植前免疫反应（PIR）和急性GVHD; Tac/MTX组的PIR发生率（p= 0.020）和100天急性GVHD累积发生率（II-IV级，38.7% vs 68.8%，p = 0.045; III-IV级，9.7% vs 34.4%，p = 0.021）显著低于Tac/mPSL组。然而，两组之间复发（p= 0.921）和巨细胞病毒再激活（p= 0.908）的发生率以及估计的总生存期（p= 0.87）和无事件生存期（p= 0.88）相当。这些数据表明，用Tac/MTX预防GVHD与有利的结果相关，包括UCBT后PIR和急性GVHD发生率降低，而无不良反应。
Post-transplant early immune disorders and engraftment failure/delay are major issues in unrelated umbilical cord blood transplantation (UCBT). We evaluated graft-versus-host disease (GVHD) prophylaxis approaches after UCBT by comparing UCBT outcomes with GVHD prophylaxis using tacrolimus plus methylprednisolone (Tac/mPSL,n= 32) to that with Tac plus methotrexate (Tac/MTX,n= 31) at a single pediatric transplantation center. The 30-day cumulative incidence rates of neutrophil engraftment and median neutrophil engraftment times in the Tac/mPSL and Tac/MTX groups were 70.1% and 90.3% and 19 and 17 days, respectively (p= 0.09). Pre-engraftment immune reactions (PIR) and acute GVHD were improved with Tac/MTX; PIR incidence (p= 0.020) and cumulative incidence of 100-day acute GVHD (grade II–IV, 38.7% vs 68.8%,p= 0.045; grade III–IV, 9.7% vs 34.4%,p= 0.021) were significantly lower in the Tac/MTX group than in the Tac/mPSL group. However, the incidence rates of relapse (p= 0.921) and cytomegalovirus reactivation (p= 0.908), and the estimated overall (p= 0.87) and event-free survival (p= 0.88) were comparable between the two groups. These data indicate that GVHD prophylaxis with Tac/MTX is associated with favorable results, including reduced PIR and acute GVHD incidence after UCBT, without adverse effects.
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影响因子：
6.2
作者：
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通讯作者：
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影响因子：
158.5
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