Mycophenolate mofetil is effective and well tolerated in the treatment of refractory acute and chronic graft-versus-host disease.
We enrolled 11 patients with refractory graft-versus-host disease (GVHD) in a prospective trial evaluating the efficacy of mycophenolate mofetil (MMF). Four (67%) of the 6 patients with acute GVHD and all 5 patients with chronic GVHD responded to MMF. Ten (91%) of the 11 patients were able to decrease steroid use (median decrease, 86%; range, 25%-100%). After a median follow-up of 18 months (range, 1-65 months), 7 patients (64%) remained alive. The adverse events were infectious complications (36%), diarrhea (27%), and neutropenia (18%); the only patient discontinuing MMF did so because of grade 4 neutropenia. This preliminary study suggests that MMF is a well-tolerated agent and has a beneficial effect in the treatment of refractory acute and chronic GVHD.
Takami
Akiyoshi
A
Department of Cellular Transplantation Biology, University Graduate School of Medicine, Kanazawa, Japan. takami@med3.m.kanazawa-u.ac.jp
Mochizuki
Kanako
K
Okumura
Hirokazu
H
Ito
Satsuki
S
Suga
Yukio
Y
Yamazaki
Hirohito
H
Yamazaki
Masahide
M
Kondo
Yukio
Y
Asakura
Hidesaku
H
Nakao
Shinji
S
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008232:Lymphoproliferative Disorders / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011446:Prospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid