Takami Akiyoshi, Mochizuki Kanako, Okumura Hirokazu, Ito Satsuki, Suga Yukio, Yamazaki Hirohito, Yamazaki Masahide, Kondo Yukio, Asakura Hidesaku, Nakao Shinji
Department of Cellular Transplantation Biology, University Graduate School of Medicine, Kanazawa, Japan.
Int J Hematol. 2006 Jan;83(1):80-5. doi: 10.1532/IJH97.05111.
We enrolled 11 patients with refractory graft-versus-host disease (GVHD) in a prospective trial evaluating the efficacy of mycophenolate mofetil (MMF). Four (67%) of the 6 patients with acute GVHD and all 5 patients with chronic GVHD responded to MMF. Ten (91%) of the 11 patients were able to decrease steroid use (median decrease, 86%; range, 25%-100%). After a median follow-up of 18 months (range, 1-65 months), 7 patients (64%) remained alive. The adverse events were infectious complications (36%), diarrhea (27%), and neutropenia (18%); the only patient discontinuing MMF did so because of grade 4 neutropenia. This preliminary study suggests that MMF is a well-tolerated agent and has a beneficial effect in the treatment of refractory acute and chronic GVHD.
我们对11例难治性移植物抗宿主病（GVHD）患者进行了一项前瞻性试验，评估霉酚酸酯（MMF）的疗效。6例急性GVHD患者中有4例（67%），所有5例慢性GVHD患者对MMF有反应。11例患者中有10例（91%）能够减少类固醇使用量（中位减少量为86%；范围为25%-100%）。中位随访18个月（范围为1-65个月）后，7例患者（64%）存活。不良事件包括感染并发症（36%）、腹泻（27%）和中性粒细胞减少（18%）；唯一停用MMF的患者是因为4级中性粒细胞减少。这项初步研究表明，MMF是一种耐受性良好的药物，对难治性急性和慢性GVHD的治疗具有有益作用。
