[Benefits of mycophenolate mofetil for refractory graft-versus-host disease].
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.
Mori
Masaki
M
Division of Hematology and Cell Therapy, Jichi Medical University Hospital.
Muroi
Kazuo
K
Matsuyama
Tomohiro
T
Oka
Satoko
S
Ono
Yoko
Y
Yamamoto
Chizuru
C
Uesawa
Mitsuyo
M
Okabe
Hiroshi
H
Matsu
Haruko
H
Tatara
Raine
R
Kikuchi
Yuji
Y
Fujiwara
Shinichiro
S
Kikuchi
Satoru
S
Sato
Kazuya
K
Ueda
Masuzu
M
Toshima
Masaki
M
Ozaki
Katsutoshi
K
Takatoku
Masaaki
M
Nagai
Tadashi
T
Ozawa
Keiya
K
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
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid