title: [Benefits of mycophenolate mofetil for refractory graft-versus-host disease].
abstract: We retrospectively evaluated the efficacy of mycophenolate mofetil (MMF) in the treatment of steroid-resistant acute and chronic graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation. Thirteen patients, ten men and three women, consisted of 5 cases of acute myelogenous leukemia, 2 of acute lymphoblastic leukemia, 2 of chronic myelogenous leukemia, 2 of lymphoblastic lymphoma, and 1 case each of adult T-cell leukemia and peripheral T-cell lymphoma. The transfusions consisted of 5 peripheral blood, 7 bone marrow and 1 cord blood from 3 mothers, 4 siblings and 6 unrelated donors with conditioning treatments, including 8 total-body irradiation-based regimens, and 2 busulfan plus cyclophosphamide and 2 reduced-intensity regimens. GVHD prophylaxis included FK506 plus methotrexate (MTX) and/or antithymocyte globulin for 9 patients, and cyclosporine and MTX for 4 patients. All patients were treated with second-line MMF for steroid-refractory acute and/or chronic GVHD, and 11 patients improved. The adverse events were tolerable except for one patient in whom grade 3 neutropenia forced discontinuation of treatment. No case of non-relapse mortality occurred. We consider that MMF is beneficial and well tolerated for treatment of steroid-refractory GVHD.
authors.affiliation: Division of Hematology and Cell Therapy, Jichi Medical University Hospital.
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Kazuo
authors.initials: K
authors.lastname: Muroi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Matsuyama
authors.forename: Satoko
authors.initials: S
authors.lastname: Oka
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ono
authors.forename: Chizuru
authors.initials: C
authors.lastname: Yamamoto
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Uesawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okabe
authors.forename: Haruko
authors.initials: H
authors.lastname: Matsu
authors.forename: Raine
authors.initials: R
authors.lastname: Tatara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Satoru
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sato
authors.forename: Masuzu
authors.initials: M
authors.lastname: Ueda
authors.forename: Masaki
authors.initials: M
authors.lastname: Toshima
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Ozaki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takatoku
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nagai
authors.forename: Keiya
authors.initials: K
authors.lastname: Ozawa
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid