Reduced-dose Cyclosporine A Combined With Short-course Methotrexat In The Prevention Of Graft-versus-host Disease In Allogeneic Peripheral Blood Stem Cell Transplantation

Objective:To evaluate the efficacy and safety of reduced-dose Cyclosporine A combined with short-course Methotrexat in the prevention of graft-versus-host disease(GVHD)in allogeneie peripheral blood stem cell transplanlatfon(allo-PBSCT).Method: Forty-one cases with hematologic disease undergoing allo-PBSCT were observed.Cyclosporin A was given prophylactically at a dose of 2-3 mg/(kg·d)intravenously from the first day before transplantation to the tenth day after transplantation,then followed by 6mg/(kg·d)orally for nine weeks.After ten weeks.the dose of Cyclosperin A was tapered by 5% weekly until the 180th day after transplantation. Methotrexat was given at a dose of 15mg/m(20.5mg/kg)intravenously on the first day after transplantation,and at a dose of 10mg/m~2 intravenously on the third,sixth,eleventh day after transplantation respectively.The states of engraftment and hematopoiesis reconstitution, the incidence and classification of GVHD, the side effects of Cyclosporin A and Methotrexat were analyzed.Results: Receptor hematopoiesis were reconstituted in all patients after allo—PBSCT.Acute GVHD occurred in four cases,among them were two cases with I grade GVHD and two cases with II grade GVHD. Chronic GVHD in six cases.The overall incidence of GVHD is 24.3%.Patients with GVHD all recovered after appropriate therapy.The side effects of reduced-dose Cyclosporin A combined with short-course Methotrexat were tolerated.Conclusions : Reduced-dose Cyclosporine A combined with short-course Methotrexat is effective and safe in the setting of allo-PBSCT.