[Comparison study on treatment of acute graft-versus-host disease with low-dose methotrexate in combination with low-dose methylprednisolone or standard-dose methylprednisolone].

OBJECTIVE: To compare the efficacy and safety of a low dose (LD) methotrexate (MTX) in combination with a LD methylprednisolone(MP) or standard dose(SD) MP in the treatment of acute graft-versus-host disease (aGVHD). METHODS: Seventy-eight developing aGVHD patients after allogeneic bone marrow transplant (allo-BMT) were divided into two contemporaneous research groups: Group A, 32 patients received intravenous MTX at a dose of 10 mg plus LD-MP (0.5 mg x kg(-1) x d(-1)); Group B, 46 patients received SD-MP (1-2 mg x kg(-1) x d(-1)). RESULTS: The overall treatment response rate in different degree aGVHD or in different involved aGVHD was similar in two groups, and so was the probability of second-line treatment, fungal infections, bacterial infections, cytomegalovirus (CMV) infection, relapse and transplant-related mortality (TRM). There was no statistical difference between the two groups. Chronic graft-versus-host disease (cGVHD) were 56.25% in Group A versus 34.78% in Group B, being no statistically significantly different (P = 0.068). In group A three of the 32 patients developed severe leukopenia and/or severe thrombocytopenia and their blood cell counts quickly returned to baseline values after drug withdrawal. In group B three of the 46 patients developed reversible hyperglycemia, after drug withdrawal, they were independent of insulin and blood glucose returned to normal values. CONCLUSION: The efficacy of two groups are similar and both safety.