Prospective trial of mycophenolate mofetil-cyclosporine A prophylaxis for acute GVHD after G-CSF stimulated allogeneic bone marrow transplantation with HLA-identical sibling donors in patients with severe aplastic anemia and hematological malignancies

Clinical Transplantation
F OstronoffR Calixto

Abstract

The combination of methotrexate and cyclosporine A (MTX-CSA) is the standard regimen for the prevention of graft vs. host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-SCT) from HLA-identical siblings. Mycophenolate mofetil and CSA (MMF-CSA) combination has been successfully used for GVHD prophylaxis after non-reduced intensity conditioning (non-RIC) allo-SCT with peripheral blood or non-G-CSF stimulated bone marrow as stem cell source. We report the results of the first prospective trial of the MMF-CSA combination for acute GVHD prophylaxis in 47 patients after non-RIC G-CSF stimulated allo-BMT (G-BMT) from HLA-identical siblings in patients with severe aplastic anemia (SAA) or hematological malignancies. Median age was 28 yr (range, 6-48 yr). Median follow-up was 22 months. The median time to neutrophil and platelets recovery were nine d (range, 8-17) and 16 d (range, 10-28), respectively. Acute GVHD of grade II-IV and chronic GVHD occurred in 51% and 27%, respectively. Overall survival rates at two yr for patients with SAA and hematological malignancies were 87% and 65%, respectively. The event-free survival at two yr for patients with hematological malignancies was 76%. We concluded that MMF-...Continue Reading

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Citations

Nov 19, 2013·Pediatric Clinics of North America·Helge D HartungMonica Bessler
Apr 24, 2012·British Journal of Clinical Pharmacology·Heather J DowningRosalind L Smyth
Jul 13, 2011·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Weijie CaoHe Huang
Mar 18, 2015·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Ali FettahBahattin Tunç
Aug 7, 2009·Transplant Infectious Disease : an Official Journal of the Transplantation Society·S GuditiN Prasad
Apr 19, 2011·Expert Review of Hematology·Amy E Dezern, Robert A Brodsky
Sep 8, 2012·Current Opinion in Hematology·William ArceseRaffaella Cerretti
Aug 12, 2020·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Mani RamziHourvash Haghighinejad

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