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Cyclosporine, methotrexate, and prednisone compared with cyclosporine and prednisone for prevention of acute graft-vs.-host disease: effect on chronic graft-vs.-host disease and long-term survival.

Publication ,  Journal Article
Ross, M; Schmidt, GM; Niland, JC; Amylon, MD; Dagis, AC; Long, GD; Nademanee, AP; Negrin, RS; O'Donnell, MR; Parker, PM; Smith, EP; Snyder, DS ...
Published in: Biol Blood Marrow Transplant
1999

Graft-vs.-host disease (GVHD) is a major predictor of outcome following allogeneic bone marrow transplantation (BMT). For patients alive at day 100 after BMT, the presence or absence of chronic GVHD is one of the most important determinants of survival and quality of life. We wished to determine the effects on chronic GVHD of two regimens used for the prophylaxis of acute GVHD: cyclosporine, methotrexate, and prednisone (CSA/MTX/PSE) and cyclosporine and prednisone (CSA/PSE). One hundred forty-nine evaluable patients were entered into the acute GVHD study. As of 31 March 1997, 63 months after the last patient underwent BMT, the median survival time was 4.5 years (range 0.09-9.9). The incidence of chronic GVHD was independent of the prophylactic regimen (55 vs. 54%), and extensive chronic GVHD occurred in 25 and 24% of patients receiving CSA/MTX/PSE and CSA/PSE, respectively. Of note, the median Karnofsky performance status of both groups was 100% (range 70-100%), reflecting the low incidence of extensive chronic GVHD. Survival rates free of chronic GVHD were 52 vs. 42% (p = 0.29) for patients receiving CSA/MTX/PSE vs. CSA/PSE. The incidence of relapse was also similar in both groups of patients. These data suggest that the combinations of CSA/MTX/PSE and CSA/PSE result in comparable chronic GVHD-free survival without an increase in leukemic relapse.

Duke Scholars

Published In

Biol Blood Marrow Transplant

DOI

ISSN

1083-8791

Publication Date

1999

Volume

5

Issue

5

Start / End Page

285 / 291

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Survival Rate
  • Recurrence
  • Prednisone
  • Middle Aged
  • Methotrexate
  • Male
  • Longitudinal Studies
  • Leukemia
  • Infant
 

Citation

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MLA
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Ross, M., Schmidt, G. M., Niland, J. C., Amylon, M. D., Dagis, A. C., Long, G. D., … Chao, N. J. (1999). Cyclosporine, methotrexate, and prednisone compared with cyclosporine and prednisone for prevention of acute graft-vs.-host disease: effect on chronic graft-vs.-host disease and long-term survival. Biol Blood Marrow Transplant, 5(5), 285–291. https://doi.org/10.1016/s1083-8791(99)70003-0
Ross, M., G. M. Schmidt, J. C. Niland, M. D. Amylon, A. C. Dagis, G. D. Long, A. P. Nademanee, et al. “Cyclosporine, methotrexate, and prednisone compared with cyclosporine and prednisone for prevention of acute graft-vs.-host disease: effect on chronic graft-vs.-host disease and long-term survival.Biol Blood Marrow Transplant 5, no. 5 (1999): 285–91. https://doi.org/10.1016/s1083-8791(99)70003-0.
Ross M, Schmidt GM, Niland JC, Amylon MD, Dagis AC, Long GD, Nademanee AP, Negrin RS, O’Donnell MR, Parker PM, Smith EP, Snyder DS, Stein AS, Wong RM, Forman SJ, Blume KG, Chao NJ. Cyclosporine, methotrexate, and prednisone compared with cyclosporine and prednisone for prevention of acute graft-vs.-host disease: effect on chronic graft-vs.-host disease and long-term survival. Biol Blood Marrow Transplant. 1999;5(5):285–291.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

ISSN

1083-8791

Publication Date

1999

Volume

5

Issue

5

Start / End Page

285 / 291

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Survival Rate
  • Recurrence
  • Prednisone
  • Middle Aged
  • Methotrexate
  • Male
  • Longitudinal Studies
  • Leukemia
  • Infant