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Folinic acid after MTX as prophylaxis for GVHD in pediatric bone marrow transplantation

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Abstract

The effect of folinic acid (FA) on toxicity secondary to the use of methotrexate (MTX) for the prevention of graft-versus-host disease (GVHD) has not been determined. We retrospectively analyzed data from 111 patients who received allogeneic bone marrow transplantation (allo-BMT) in our institution. Fifty patients did not receive FA (non-FA), 37 received FA four times (low dose, LD-FA), and 24 received FA 25 times (high dose, HD-FA) in BMT. No significant differences were observed in the severity of stomatitis after allo-BMT among the three groups while the median of peak value of ALT in HD-FA was significantly lower (P = 0.031). The median time to neutrophil engraftment after allo-BMT in the HD-FA group was significantly shorter than that in the non-FA group (P = 0.034). No significant difference in the median time to neutrophil engraftment was observed between the LD-FA and non-FA groups (P = 0.44). Stepwise multiple regression analysis revealed that the determinants of the shorter duration of neutropenia were transfused total nucleated cell dose (P = 0.001) and the administration of HD-FA (P = 0.036). There was no significant difference in 3-year overall survival among the three groups. Frequent administration of FA may reduce the time to neutrophil engraftment after hematopoietic stem cell transplantation.

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Acknowledgments

We thank our nursing and medical staff of the HSCT unit for the provision of excellent patient care and continuing support.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Pediatrics, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, Japan

    Yuichi Kodama, Reiji Fukano, Maiko Noguchi, Jun Okamura & Jiro Inagaki

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  1. Yuichi Kodama
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  2. Reiji Fukano
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  3. Maiko Noguchi
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  4. Jun Okamura
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  5. Jiro Inagaki
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Correspondence to Jiro Inagaki.

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Kodama, Y., Fukano, R., Noguchi, M. et al. Folinic acid after MTX as prophylaxis for GVHD in pediatric bone marrow transplantation. Int J Hematol 101, 92–98 (2015). https://doi.org/10.1007/s12185-014-1712-x

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  • DOI: https://doi.org/10.1007/s12185-014-1712-x

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