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

Xiaoli Zhu; Xiaoyu Lai; Yi Luo; Jimin Shi; Yamin Tan; Weiyan Zheng; Jingsong He; Wanzhuo Xie; Li Li; Jie Zhang; Xiujin Ye; Maofang Lin; Zhen Cai; He Huang

doi:10.1016/j.leukres.2013.06.016

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.

Authors

Xiaoli Zhu¹, Xiaoyu Lai, Yi Luo, Jimin Shi, Yamin Tan, Weiyan Zheng, Jingsong He, Wanzhuo Xie, Li Li, Jie Zhang, Xiujin Ye, Maofang Lin, Zhen Cai, He Huang

Affiliation

¹ Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.

PMID: 23849987
DOI: 10.1016/j.leukres.2013.06.016

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