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Efficacy of folinic acid in preventing oral mucositis in allogeneic hematopoietic stem cell transplant patients receiving MTX as prophylaxis for GVHD.

Abstract
As the safety of folinic acid administration and its efficacy for reducing the toxicity of MTX remain controversial, we assessed the effect of folinic acid administration after MTX treatment for GVHD prophylaxis on the incidence of oral mucositis and acute GVHD. We retrospectively analyzed data for 118 patients who had undergone allogeneic hematopoietic SCT and had received MTX for GVHD prophylaxis. Multivariate analysis showed that systemic folinic acid administration significantly reduced the incidence of severe oral mucositis (odds ratio (OR)=0.13, 95% confidence interval (CI) 0.04-0.73, P=0.014). There was also a tendency for a lower incidence of severe oral mucositis in patients who received folinic acid mouthwash (OR=0.39, 95%CI 0.15-1.00, P=0.051). No significant difference was observed in the incidence of acute GVHD between patients who received systemic folinic acid administration and those who did not (P=0.88). Systemic folinic acid administration and mouthwash appear to be useful for reducing the incidence of severe oral mucositis in patients who have received allogeneic hematopoietic SCT using MTX as GVHD prophylaxis.
AuthorsJ Sugita, T Matsushita, H Kashiwazaki, M Kosugi, S Takahashi, K Wakasa, S Shiratori, M Ibata, Y Shono, A Shigematsu, M Obara, K Fujimoto, T Endo, M Nishio, T Kondo, S Hashino, J Tanaka, M Asaka, M Imamura
JournalBone marrow transplantation (Bone Marrow Transplant) Vol. 47 Issue 2 Pg. 258-64 (Feb 2012) ISSN: 1476-5365 [Electronic] England
PMID21423118 (Publication Type: Journal Article)
Chemical References
  • Immunosuppressive Agents
  • Leucovorin
  • Methotrexate
Topics
  • Adolescent
  • Adult
  • Aged
  • Female
  • Graft vs Host Disease (drug therapy, prevention & control)
  • Hematopoietic Stem Cell Transplantation (adverse effects, methods)
  • Humans
  • Immunosuppressive Agents (therapeutic use)
  • Leucovorin (therapeutic use)
  • Male
  • Methotrexate (therapeutic use)
  • Middle Aged
  • Retrospective Studies
  • Stomatitis (drug therapy, prevention & control)
  • Transplantation Conditioning (adverse effects, methods)
  • Transplantation, Homologous
  • Young Adult

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