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Mycophenolate mofetil use after unrelated hematopoietic stem cell transplantation for prophylaxis and treatment of graft‐vs.‐host disease in adult patients in Japan |
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| Authors: | Minako Iida Takahiro Fukuda Naoyuki Uchida Makoto Murata Nobuyuki Aotsuka Kentaro Minagawa Kazuteru Oohashi Kentaro Fukushima Tadakazu Kondo Tetsuya Eto Toshihiro Miyamoto Yasuo Morishima Tokiko Nagamura Yoshiko Atsuta Ritsuro Suzuki |
| Institution: | 1. Department of HSCT Data Management and Biostatistics, Nagoya University School of Medicine, , Nagoya, Japan;2. Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University School of Medicine, , Aichi, Japan;3. Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, , Tokyo, Japan;4. Department of Hematology, Federation of National Public Service Personnel Mutual Aid Association Toranomon Hospital, , Tokyo, Japan;5. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, , Nagoya, Japan;6. Division of Hematology‐Oncology, Japanese Red Cross Society Narita Hospital, , Chiba, Japan;7. Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, , Hyogo, Japan;8. Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, , Tokyo, Japan;9. Department of Hematology and Oncology, Osaka University Hospital, , Osaka, Japan;10. Department of Hematology/Oncology, Kyoto University Hospital, , Kyoto, Japan;11. Department of Hematology, Hamanomachi Hospital, , Japan;12. Department of Hematology and Oncology, Kyusyu University Hospital, , Japan;13. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, , Aichi, Japan;14. Department of Cell Processing and Transfusion, The Institute of Medical Science, The University of Tokyo, , Tokyo, Japan |
| Abstract: | Our previous study of 301 patients who received hematopoietic stem cell transplantation (HSCT) from related donors demonstrated the efficacy of mycophenolate mofetil (MMF) for prophylaxis and treatment of graft‐vs.‐host disease (GVHD). In this study, we investigated the safety and efficacy of MMF in 716 adult patients who received unrelated HSCT. The incidences of Grade II–IV and III–IV acute GVHD in the prophylactic administration group were 38.3% and 14.3%, respectively. These rates were not statistically significant when evaluating the MMF dosage and graft source. The incidences of limited and extensive chronic GVHD were 16.6% and 11.1%, respectively. In the therapeutic administration group, 69.1% of the subjective symptoms for both acute and chronic GVHD improved. With respect to the adverse events, 75 infections and 50 cases of diarrhea were observed, and the frequency of these events increased with increasing MMF dose. The overall survival rate was 36.4% after a median follow‐up period of three yr. This study shows that MMF is safe and effective for the prevention and treatment of GVHD in patients who have received HSCT from unrelated donors. |
| Keywords: | graft‐vs ‐host disease mycophenolate mofetil unrelated allogeneic stem cell transplantation |