Extended mycophenolate mofetil administration beyond day 30 in allogeneic hematopoietic stem cell transplantation as preemptive therapy for severe graft-versus-host disease

Transplantation Proceedings
Shinichiro NishikawaToshimitsu Matsui

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.

References

Apr 13, 2004·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Ifeyinwa OsunkwoMitchell S Cairo
Jun 29, 2005·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Richard A NashRainer Storb
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Citations

May 18, 2012·International Journal of Hematology·Kentaro MinagawaToshimitsu Matsui
Jan 8, 2016·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Randy M WindreichRaman Venkataramanan
Jul 30, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Betty Ky Hamilton, Matt Kalaycio
Apr 9, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Zaid Al-KadhimiJoseph Uberti
Apr 13, 2015·International Journal of Hematology·Makoto Murata

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