Niveau de preuve du suivi thérapeutique pharmacologique de l'acide mycophénolique administré pour la prévention des réactions du greffon contre l'hôte au cours des greffes de cellules souches avec un conditionnement réduit

Abstract

Mycophenolic acid (MPA) is more and more used to prevent GVHD (Graft Versus Host Disease) during hematopoietic stem cell transplantation with reduce-intensity conditioning. If several facts argue in favor of therapeutic drug monitoring, the used pharmacokinetic parameter is to be defined. Especially, the choice between total or ultrafilterable MPA is still under debate even if therapeutic drug monitoring seems to be more practicable with total MPA. The role of other factors implied in GVHD occurrence are also to be assessed in studies which aim at assessing therapeutic drug monitoring of MPA in such situation. For theses reasons, the level evidence of MPA as GVHD prophylaxis during hematopoietic stem cell transplantation with reduce-intensity conditioning is potentially useful.

Keywords: MPA; acide mycophénolique; conditionnement atténué; greffe de cellules souches; hematopoietic stem cells; level of evidence; niveau de preuve; transplantation reduced-intensity conditioning.