A comparison of tacrolimus and cyclosporine combined with methotrexate for graft-versus-host disease prophylaxis, stratified by stem cell source: a retrospective nationwide survey

作者：Sakai Rika^*; Taguri Masataka; Oshima Kumi; Mori Takehiko; Ago Hiroatsu; Adachi Souichi; Morita Satoshi; Taniguchi Shuichi; Fukuda Takahiro; Ohashi Kazuteru; Eto Tetsuya; Miyamura Koichi; Iwato Koji; Kobayashi Naoki; Kanamori Heiwa; Morishima Yasuo; Nagamura Inoue Tokiko; Sakamaki Hisashi; Atsuta Yoshiko; Murata Makoto

来源：International Journal of Hematology, 2016, 103(3): 322-333.

DOI：10.1007/s12185-016-1939-9

• Tacrolimus
• Cyclosporine
• Methotrexate
• Graft-versus-host disease

This nationwide, retrospective study compared the efficacy of cyclosporine and tacrolimus with methotrexate (CsA/MTX and TAC/MTX) for acute graft-versus-host disease (aGVHD) prevention and transplant-related outcomes. Data were obtained from the Transplant Registry Unified Management Program of the Japan Society for Hematopoietic Cell Transplantation for a parts per thousand yen16-year-old leukemia patients who received CsA/MTX or TAC/MTX after bone marrow transplantation and peripheral blood stem cell transplantation from serological HLA-matched related donors (MRD), HLA 8/8 allele-matched, or one allele-mismatched unrelated bone marrow (UBM), or 0-2 antigen-mismatched unrelated cord blood (UCB) transplantation between January 2005 and December 2009. Separate analyses were performed for each cohort. Adjusted multivariate analyses indicated that in the MRD (n = 1524) and the UBM (n = 1466) cohorts, TAC/MTX significantly reduced grade II-IV aGVHD risk (HR 0.58, P = 0.006 and HR 0.77, P = 0.015, respectively) without affecting the other transplant-related outcomes. In the UCB cohort (n = 925), TAC/MTX significantly reduced the risk of non-relapse mortality (HR 0.63, P = 0.027) and chronic GVHD (HR 0.60, P = 0.02) without significant effects on grade II-IV aGVHD (HR 0.83, P = 0.21). Our results may provide the most up-to-date data regarding GVHD prevention in Japan.

• 出版日期2016-3
• 单位河北医科大学