Combination of low-dose mycophenolate mofetil with cyclosporine and methotrexate as GVHD prophylaxis in unrelated donor allogeneic stem cell transplantation

Leuk Res. 2013 Sep;37(9):1046-51. doi: 10.1016/j.leukres.2013.06.016. Epub 2013 Jul 10.

Abstract

We report the results of HLA-matched unrelated donor allogeneic stem cell transplantation with new GVHD prophylaxis regimen consisted of cyclosporine, methotrexate and low-dose mycophenolate mofetil in 139 patients with hematologic malignancies. The incidence of grades II-IV and III-IV acute GVHD were 43.0% and 17.3%, respectively. The incidence of chronic GVHD was 42.1%, with 16.5% extensive grade. The cumulative incidence of transplant-related mortality at 100 days and 3 years were 7.9% and 29.7%, respectively. Three-year overall survival, disease-free survival and relapse incidence were 58.7%, 55.3% and 19.6%, respectively. These results suggest the new regime may be effective for the prophylaxis of acute and chronic GVHD in unrelated donor transplantation.

Keywords: Allogeneic stem cell transplantation; GVHD; Mycophenolate mofetil; Unrelated donor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cyclosporine / administration & dosage*
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Graft Rejection / diagnosis
  • Graft Rejection / drug therapy*
  • Graft Rejection / etiology
  • Graft Survival / drug effects
  • Graft vs Host Disease / diagnosis
  • Graft vs Host Disease / drug therapy*
  • Graft vs Host Disease / etiology
  • Hematologic Neoplasms / complications*
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Histocompatibility Testing
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Male
  • Methotrexate / administration & dosage*
  • Middle Aged
  • Morbidity
  • Mycophenolic Acid / administration & dosage
  • Mycophenolic Acid / analogs & derivatives*
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / etiology
  • Prognosis
  • Survival Rate
  • Transplantation, Homologous
  • Unrelated Donors
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Cyclosporine
  • Mycophenolic Acid
  • Methotrexate