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Graft-Versus-Host Disease

Low-dose MTX combined with low-dose methylprednisolone as a first-line therapy for the treatment of acute GVHD: safety and feasibility

Bone Marrow Transplantation volume 46, pages 892–898 (2011)Cite this article

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Abstract

To study the efficacy and safety of a low dose of MTX combined with a low dose of methylprednisolone (MP) as a first-line therapy in the treatment of acute GVHD (aGVHD) after allogeneic hematopoietic SCT, 32 patients received i.v. MTX at a dose of 10 mg or oral MTX at a dose of 15 mg every 3–7 days (repeated at day 3 after the first dose and then at a weekly interval) combined with a low dose of MP (0.5 mg/kg/day) until a complete or partial response was achieved, or until treatment failure or intolerable side effects occurred. The overall treatment response rate was 81% (26/32 patients) and the response rate at day 28 was 75% (24/32 patients). The response rate for GVHD involving various organs was 88% (23/26) in the skin, 75% (3/4) in the liver and 81% (9/11) in the gut. Grade 3 toxicities occurred in only three patients presenting cytopenias. The estimated survival at 2 years was 77%. From this analysis, MTX in combination with a low dose of MP appears to be a well-tolerated, effective and inexpensive regime when used as a first-line treatment for aGVHD.

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Acknowledgements

This work was supported by the National Outstanding Young Scientist's Foundation of China (Grant no. 30725038), the Program for Innovative Research Team in University (Grant no. IRT 0702) and the Leading Program of Clinical Faculty accredited by the Ministry of Health of China. We thank the American Journal Experts for reviewing the paper in English. We thank every faculty member who has participated in these studies.

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  1. Institute of Hematology, Peking University People's Hospital, Beijing, China

    Y Wang, L P Xu, K Y Liu, D H Liu, J Wang, H Chen, Y H Chen, W Han & X J Huang

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  1. Y Wang
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Correspondence to X J Huang.

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Wang, Y., Xu, L., Liu, K. et al. Low-dose MTX combined with low-dose methylprednisolone as a first-line therapy for the treatment of acute GVHD: safety and feasibility. Bone Marrow Transplant 46, 892–898 (2011). https://doi.org/10.1038/bmt.2010.197

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