Incidence of hypertension after marrow transplantation among 112 patients randomized to either cyclosporine or methotrexate as graft‐versus‐host disease prophylaxis

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Abstract
SummaryWe investigated the frequency of hypertension (sustained diastolic blood pressure ≥90 mmHg) in 112 patients given HLA‐identical marrow grafts. Patients were conditioned with 2 × 60 mg/kg of cyclophosphamide and 6 × 2 Gy of total body irradiation and randomized to receive as graft‐versus‐host disease prophylaxis either the standard methotrexate regimen (n= 61) or cyclosporine (n= 51), starting on day −1 as 12.5 mg/kg/d orally or as 3 mg/kg/d i.v. and later converting to p.o. when oral intake was tolerated. Kaplan‐Meier estimates indicate a 60% incidence of hypertension in the first 120 d in patients given cyclosporine (median time to onset: 4 d post transplant) compared to 20% in patients given methotrexate (PPP<0.0001). Age, sex, underlying disease, cyclosporine trough levels, and renal function had no significant association with hypertension. Early therapy of hypertension in cyclosporine‐treated patients appears to be indicated.