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

摘要

Since the safety of folinic acid administration and its efficacy for reducing the toxicity of methotrexate (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 stem cell transplantation and had received MTX for GVHD prophylaxis. Multivariate analysis showed that systemic folinic acid administration significantly reduced the incidence of severe oral mucositis (OR = 0.13, 95%CI 0.04-0.73, P = 0.014). There was also a tendency for 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 mucositis in patients who have received allogeneic hematopoietic stem cell transplantation using MTX as GVHD prophylaxis.