Nishikawa S, Okamura A, Yamamori M, Minagawa K, Kawamori Y, Kawano Y, Kawano H, Ono K, Katayama Y, Shimoyama M, Matsui T
Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Transplant Proc. 2009 Nov;41(9):3873-6. doi: 10.1016/j.transproceed.2009.06.231.
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.
