Mycophenolate mofetil for the treatment of acute and chronic GVHD in bone marrow transplant patients.
The efficacy and safety of mycophenolate mofetil (MMF) in combination with CsA and prednisolone for the treatment of acute and chronic GVHD (aGVHD and cGVHD, respectively) after BMT and PBSCT from HLA-mismatched and -matched donors was evaluated in an open single center trial. Twenty-four patients, 17-48 years of age, with acute (n = 17) and chronic GVHD (n = 7) were treated with 2 g MMF daily in addition to CsA and prednisolone. Overall grade improvement of aGVHD was found in 11 of 17 (65%) patients treated with MMF. MMF therapy in the treatment of cGVHD led to moderate improvement in three of six patients with limited cGVHD. The most common adverse hematologic events of MMF were leukopenia (n = 6), anemia (n = 4) and thrombocytopenia (n = 3). Hematological adverse events were not severe and did not require the discontinuation of MMF. In this preliminary study, we have shown that MMF can be used safely for the treatment of aGVHD. In addition, the MMF therapy resulted in significant dose reduction of prednisolone for the treatment of GVHD.
Clinic for Bone Marrow Transplantation and Hematology/Oncology, Idar-Oberstein, Germany.
N
N
Basara
W I
WI
Blau
E
E
Römer
M
M
Rudolphi
M
M
Bischoff
D
D
Kirsten
H
H
Sanchez
S
S
Günzelmann
A A
AA
Fauser
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000139:chemically induced; D016026:Bone Marrow Transplantation; D002908:Chronic Disease; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D009173:Mycophenolic Acid