title: Mycophenolate mofetil use after unrelated hematopoietic stem cell transplantation for prophylaxis and treatment of graft-vs.-host disease in adult patients in Japan.
abstract: Our previous study of 301 patients who received hematopoietic stem cell transplantation (HSCT) from related donors demonstrated the efficacy of mycophenolate mofetil (MMF) for prophylaxis and treatment of graft-vs.-host disease (GVHD). In this study, we investigated the safety and efficacy of MMF in 716 adult patients who received unrelated HSCT. The incidences of Grade II-IV and III-IV acute GVHD in the prophylactic administration group were 38.3% and 14.3%, respectively. These rates were not statistically significant when evaluating the MMF dosage and graft source. The incidences of limited and extensive chronic GVHD were 16.6% and 11.1%, respectively. In the therapeutic administration group, 69.1% of the subjective symptoms for both acute and chronic GVHD improved. With respect to the adverse events, 75 infections and 50 cases of diarrhea were observed, and the frequency of these events increased with increasing MMF dose. The overall survival rate was 36.4% after a median follow-up period of three yr. This study shows that MMF is safe and effective for the prevention and treatment of GVHD in patients who have received HSCT from unrelated donors.
authors.affiliation: Department of HSCT Data Management and Biostatistics, Nagoya University School of Medicine, Nagoya, Japan; Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University School of Medicine, Aichi, Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Iida
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Uchida
authors.forename: Makoto
authors.initials: M
authors.lastname: Murata
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Aotsuka
authors.forename: Kentaro
authors.initials: K
authors.lastname: Minagawa
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Oohashi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Fukushima
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Kondo
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Eto
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morishima
authors.forename: Tokiko
authors.initials: T
authors.lastname: Nagamura
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Atsuta
authors.forename: Ritsuro
authors.initials: R
authors.lastname: Suzuki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology / Q000628:therapy*; D006402:Hematologic Diseases / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D014019:Tissue Donors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid
keywords: graft-vs.-host disease; mycophenolate mofetil; unrelated allogeneic stem cell transplantation