1. Cyclosporine, methotrexate, and prednisone compared with cyclosporine and prednisone for prophylaxis of acute graft-versus-host disease
- Author
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Chao, Nelson J., Schmidt, Gerhard M., Niland, Joyce C., Amylon, Michael D., Dagis, Andrew C., Long, Gwynn D., Nademanee, Auayporn P., Negrin, Robert S., O'Donnell, Margaret R., Parker, Pablo M., Smith, Eileen P., Snyder, David S., Stein, Anthony S., Wong, Ruby M., Blume, Karl G., and Forman, Stephen J.
- Subjects
Graft versus host reaction -- Prevention ,Bone marrow -- Transplantation ,Transplantation of organs, tissues, etc. -- Complications ,Cyclosporine -- Evaluation ,Prednisone -- Evaluation - Abstract
A combination of three drugs, cyclosporine, methotrexate and prednisone, appears to be better able to prevent acute graft-versus-host disease (GVHD) than the administration of cyclosporine and prednisone alone in recipients of a bone marrow transplant of a different genetic composition. Although two trials of immunosuppressive drugs such as cyclosporine and methotrexate demonstrated that the use of both was more successful than the use of either alone in preventing GVHD, the disease continued to develop in 20% to 30% of patients with the acute form of GVHD. The addition of prednisone strengthened the drug program's ability to effectively treat GVHD. Among patients in two treatment groups, one of which received methotrexate as part of the drug combination and another that did not, the group whose medication included methotrexate developed acute GVHD less often than those in the other group. A lower rate of acute GVHD did not lead to an increased relapse of leukemia or lymphoma. Disease-free survival at three years was also unaffected.
- Published
- 1993