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Titolo:
Phase 3 study comparing methotrexate and tacrolimus with methotrexate and cyclosporine for prophylaxis of acute graft-versus-host disease after marrow transplantation from unrelated donors
Autore:
Nash, RA; Antin, JH; Karanes, C; Fay, JW; Avalos, BR; Yeager, AM; Przepiorka, D; Davies, S; Petersen, FB; Bartels, P; Buell, D; Fitzsimmons, W; Anasetti, C; Storb, R; Ratanatharathorn, V;
Indirizzi:
Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98109 USA Fred Hutchinson Canc Res Ctr Seattle WA USA 98109 , Seattle, WA 98109 USA Univ Washington, Dept Med, Seattle, WA USA Univ Washington Seattle WA USA niv Washington, Dept Med, Seattle, WA USA Dana Farber Canc Inst, Boston, MA 02115 USA Dana Farber Canc Inst Boston MA USA 02115 Canc Inst, Boston, MA 02115 USA Brigham & Womens Hosp, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 mens Hosp, Boston, MA 02115 USA Wayne State Univ, Detroit, MI USA Wayne State Univ Detroit MI USAWayne State Univ, Detroit, MI USA Baylor Univ, Sammons Canc Ctr, Dallas, TX USA Baylor Univ Dallas TX USABaylor Univ, Sammons Canc Ctr, Dallas, TX USA Ohio State Univ Hosp, Columbus, OH 43210 USA Ohio State Univ Hosp Columbus OH USA 43210 v Hosp, Columbus, OH 43210 USA Emory Clin, Atlanta, GA 30322 USA Emory Clin Atlanta GA USA 30322Emory Clin, Atlanta, GA 30322 USA Univ Texas, MD Anderson Canc Ctr, Houston, TX 77030 USA Univ Texas Houston TX USA 77030 Anderson Canc Ctr, Houston, TX 77030 USA Fairview Univ Hosp, Minneapolis, MN USA Fairview Univ Hosp Minneapolis MNUSA iew Univ Hosp, Minneapolis, MN USA Univ Utah, Sch Med, Salt Lake City, UT USA Univ Utah Salt Lake City UT USA iv Utah, Sch Med, Salt Lake City, UT USA Fujisawa Healthcare, Deerfield, IL USA Fujisawa Healthcare Deerfield IL USA isawa Healthcare, Deerfield, IL USA Univ Michigan, Ann Arbor, MI 48109 USA Univ Michigan Ann Arbor MI USA 48109 iv Michigan, Ann Arbor, MI 48109 USA
Titolo Testata:
BLOOD
fascicolo: 6, volume: 96, anno: 2000,
pagine: 2062 - 2068
SICI:
0006-4971(20000915)96:6<2062:P3SCMA>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHRONIC MYELOGENOUS LEUKEMIA; ACUTE LYMPHOBLASTIC-LEUKEMIA; CHRONIC MYELOID-LEUKEMIA; SEVERE APLASTIC-ANEMIA; T-CELL DEPLETION; TERM FOLLOW-UP; BONE-MARROW; CONTROLLED TRIAL; ACUTE GVHD; PREVENTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
57
Recensione:
Indirizzi per estratti:
Indirizzo: Nash, RA Fred Hutchinson Canc Res Ctr, Div Clin Res, 1100 Fairview Ave N,D1-100,POB19024, Seattle, WA 98109 USA Fred Hutchinson Canc Res Ctr 1100 Fairview Ave N,D1-100,POB 19024 Seattle WA USA 98109
Citazione:
R.A. Nash et al., "Phase 3 study comparing methotrexate and tacrolimus with methotrexate and cyclosporine for prophylaxis of acute graft-versus-host disease after marrow transplantation from unrelated donors", BLOOD, 96(6), 2000, pp. 2062-2068

Abstract

After the transplantation of unmodified marrow from human leukocyte antigen-, matched unrelated donors receiving cyclosporine (CSP) and methotrexate (MTX), the incidence of acute graft-versus-host disease (GVHD) is greater than 75%, Tacrolimus is a macrolide compound that, in previous preclinical and clinical studies, was effective in combination with MTX for the prevention of acute GVHD, Between March 1995 and September 1996, 180 patients were randomized in a phase 3, open-label, multicenter study to determine whethertacrolimus combined with a short course of MTX (n = 90), more than CSP anda short course of MTX (n = 90), would reduce the incidence of acute GVHD after marrow transplantation from unrelated donors, There was a significant trend toward decreased severity of acute GVHD across all grades (P =.005), Based on the Kaplan-Meier estimate, the probability of grade II-IV acute GVHD in the tacrolimus group (56%) was significantly lower than in the CSP group (74%; P =.0002). Use of glucocorticoids for the management of GVHD was significantly lower with tacrolimus than with CSP (65% vs 81%, respectively; P =.019). The number of patients requiring dialysis in the first 100 dayswas similar (tacrolimus, 9; CSP, 8), Overall and relapse-free survival rates for the tacrolimus and CSP arms at 2 years was 54% versus 50% (P =.46) and 47% versus 42% (P =.58), respectively. The combination of tacrolimus andMTX after unrelated donor marrow transplantation significantly decreased the risk for acute GVHD than did the combination of CSP and MTX, with no significant increase in toxicity, infections, or leukemia relapse.(Blood. 2000;96:2062-2068) (C) 2000 by The American Society of Hematology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/06/20 alle ore 02:22:33