A RANDOMIZED STUDY OF THE PREVENTION OF ACUTE GRAFT VERSUS HOST-DISEASE
A RANDOMIZED STUDY OF THE PREVENTION OF ACUTE GRAFT VERSUS HOST-DISEASE
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DOI：
10.1056/nejm198202183060703
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发表时间：
1982-01-01
影响因子：
158.5
通讯作者：
NESBIT, ME
中科院分区：
文献类型：
--
作者：
RAMSAY, NKC;KERSEY, JH;NESBIT, ME
急性移植物vs.宿主疾病是异基因骨髓移植中的主要问题。对再生障碍性贫血、急性淋巴细胞白血病、急性非淋巴细胞白血病、淋巴瘤和慢性粒细胞白血病接受移植的患者进行了一项随机研究，以比较两种方案预防急性移植物-vs.宿主疾病35例患者接受甲氨蝶呤单药治疗; 32例接受甲氨蝶呤、抗胸腺细胞球蛋白和泼尼松治疗。在单独接受甲氨蝶呤治疗的患者中，48%的患者发生急性移植物抗宿主疾病，而接受甲氨蝶呤，抗胸腺细胞球蛋白和泼尼松的患者为21%（P = 0.01）。受体的年龄是发生急性移植物抗宿主病的重要因素。宿主疾病：老年患者的发病率较高（P = 0.001）。联合应用甲氨蝶呤、抗胸腺细胞球蛋白和强的松可显著降低急性移植物抗-宿主疾病，并应用于预防接受异基因骨髓移植的患者的这种疾病。
Acute graft-vs.-host disease is a major problem in allogeneic bone marrow transplantation. A randomized study was made of patients receiving transplants for aplastic anemia, acute lymphoblastic leukemia, acute nonlymphocytic leukemia, lymphoma and chronic myelogenous leukemia to compare the effectiveness of 2 regimens in the prevention of acute graft-vs.-host disease. Thirty-five patients received methotrexate alone; 32 received methotrexate, antithymocyte globulin and prednisone. Of the patients who received methotrexate alone, 48% had acute graft-vs.-host disease, compared with 21% of those who received methotrexate, antithymocyte globulin and prednisone (P = 0.01). The age of the recipient was a significant factor in the development of acute graft-vs.-host disease: older patients had a higher incidence of the disease (P = 0.001). The combination of methotrexate, antithymocyte globulin and prednisone significantly decreased the incidence of acute graft-vs.-host disease and should be used to prevent this disorder in patients receiving allogeneic marrow transplants.