title: Extended mycophenolate mofetil administration beyond day 30 in allogeneic hematopoietic stem cell transplantation as preemptive therapy for severe graft-versus-host disease.
abstract: To prevent acute graft-versus-host disease (GVHD), mycophenolate mofetil (MMF) combined with calcineurin inhibitors have been used in allogeneic hematopoietic stem cell transplantation (allo-SCT). Previous studies commonly utilize MMF treatment until day 30 after allo-SCT. However, the feasibility of continuous administration after day 30 has not been well evaluated. We retrospectively assessed the safety and efficacy of extended drug administration. Twenty-five patients ceased MMF at day 30 (group A); whereas, 16 patients (group B) received extended regimens depending on individual risk factors for GVHD. No severe adverse events were observed in either group. Although the cumulative incidence (CI) of grade I to IV GVHD at day 100 was comparable between the 2 groups, the CI of grade II to IV GVHD was less among group B (12.5%) compared with group A (42.3%). Extended MMF administration may be safe and beneficial as preemptive therapy to reduce the development of moderate-to-severe acute GVHD.
authors.affiliation: Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nishikawa
authors.forename: A
authors.initials: A
authors.lastname: Okamura
authors.forename: M
authors.initials: M
authors.lastname: Yamamori
authors.forename: K
authors.initials: K
authors.lastname: Minagawa
authors.forename: Y
authors.initials: Y
authors.lastname: Kawamori
authors.forename: Y
authors.initials: Y
authors.lastname: Kawano
authors.forename: H
authors.initials: H
authors.lastname: Kawano
authors.forename: K
authors.initials: K
authors.lastname: Ono
authors.forename: Y
authors.initials: Y
authors.lastname: Katayama
authors.forename: M
authors.initials: M
authors.lastname: Shimoyama
authors.forename: T
authors.initials: T
authors.lastname: Matsui
mesh_terms: D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007938:Leukemia / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009190:Myelodysplastic Syndromes / Q000188:drug therapy / Q000601:surgery; D012449:Safety; D016559:Tacrolimus / Q000627:therapeutic use; D013997:Time Factors; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid; D016559:Tacrolimus