Mori Masaki, Muroi Kazuo, Matsuyama Tomohiro, Oka Satoko, Ono Yoko, Yamamoto Chizuru, Uesawa Mitsuyo, Okabe Hiroshi, Matsu Haruko, Tatara Raine, Kikuchi Yuji, Fujiwara Shinichiro, Kikuchi Satoru, Sato Kazuya, Ueda Masuzu, Toshima Masaki, Ozaki Katsutoshi, Takatoku Masaaki, Nagai Tadashi, Ozawa Keiya
Division of Hematology and Cell Therapy, Jichi Medical University Hospital.
Rinsho Ketsueki. 2007 Aug;48(8):624-31.
We retrospectively evaluated the efficacy of mycophenolate mofetil (MMF) in the treatment of steroid-resistant acute and chronic graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation. Thirteen patients, ten men and three women, consisted of 5 cases of acute myelogenous leukemia, 2 of acute lymphoblastic leukemia, 2 of chronic myelogenous leukemia, 2 of lymphoblastic lymphoma, and 1 case each of adult T-cell leukemia and peripheral T-cell lymphoma. The transfusions consisted of 5 peripheral blood, 7 bone marrow and 1 cord blood from 3 mothers, 4 siblings and 6 unrelated donors with conditioning treatments, including 8 total-body irradiation-based regimens, and 2 busulfan plus cyclophosphamide and 2 reduced-intensity regimens. GVHD prophylaxis included FK506 plus methotrexate (MTX) and/or antithymocyte globulin for 9 patients, and cyclosporine and MTX for 4 patients. All patients were treated with second-line MMF for steroid-refractory acute and/or chronic GVHD, and 11 patients improved. The adverse events were tolerable except for one patient in whom grade 3 neutropenia forced discontinuation of treatment. No case of non-relapse mortality occurred. We consider that MMF is beneficial and well tolerated for treatment of steroid-refractory GVHD.
