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Low incidence of acute graft-versus-host disease by the administration of
methotrexate and cyclosporine in Japanese leukemia patients after bone
marrow transplantation from human leukocyte antigen compatible siblings;
possible role of genetic homogeneity. The Nagoya Bone Marrow
Transplantation Group
Y Morishima, Y Morishita, M Tanimoto, R Ohno, H Saito, K Horibe, N Hamajima, K Naito, K Yamada and S Yokomaku
First Department of Internal Medicine, Nagoya University School of
Medicine, Japan.
Japanese patients with leukemia who received bone marrow from human
leukocyte antigen (HLA)-compatible siblings had a low incidence of acute
graft-versus-host disease (GVHD). Twenty-five (21%) of 120 patients
developed moderate (grade II) to severe (grades III to IV) acute GVHD.
Severe GVHD was only seen in patients older than 20 years of age. It is
also notable that only 2 (5%) of 39 patients who received the combination
of methotrexate and cyclosporine (MTX/CSP) for the prevention of GVHD
developed grade II acute GVHD, and none developed grades III to IV acute
GVHD. Thirteen (30%) of 44 patients receiving MTX alone and 10 (27%) of 37
patients receiving CSP alone developed grades II to IV acute GVHD.
Multivariate life-table analysis indicated that the prophylaxis by MTX/CSP
was the risk factor for the low incidence of grades II to IV acute GVHD.
Compared with the reported incidence of acute GVHD in the patients of the
United States, lower incidence of acute GVHD in Japanese BMT patients might
be attributable to a lesser degree of genetic diversity in
histocompatibility antigens among Japanese.
Volume 74,
Issue 6,
pp. 2252-2256,
11/01/1989
Copyright © 1989 by The American Society of Hematology
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