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Therapy with mycophenolate mofetil for refractory acute and chronic GVHD.

Furlong, Terry and Martin, Paul and Flowers, Mary E.D. and Carnevale-Schianca, Fabrizio and Yatscoff, Randy and Chauncey, Thomas and Appelbaum, Frederick R. and Deeg, H. Joachim and Doney, Kris and Witherspoon, Robert and Storer, Barry and Sullivan, Keith M. and Storb, Rainer and Nash, Richard A. (2009) Therapy with mycophenolate mofetil for refractory acute and chronic GVHD. Bone marrow transplantation, 44 (11). pp. 739-748. ISSN 1476-5365

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Article URL: http://www.nature.com/bmt/journal/vaop/ncurrent/ab...

Abstract

We evaluated the pharmacokinetics and efficacy of oral mycophenolate mofetil (MMF) for treatment of refractory GVHD. In a prospective study of acute GVHD, 9 of 19 patients (47%) had a response and 10 (53%) had no improvement. Survival at 6 and 12 months after the start of MMF was 37 and 16%, respectively. In a retrospective study of acute GVHD, 14 of 29 patients (48%) had a response and 15 (52%) had no improvement. Survival at 6 and 12 months was 55 and 52%, respectively. In a prospective study of chronic GVHD, the cumulative incidence of disease resolution and withdrawal of all systemic immunosuppressive treatment was 9, 17 and 26% at 12, 24 and 36 months, respectively, after starting MMF. Thirteen patients (59%) required additional systemic immunosuppressive treatment for chronic GVHD. Nine of the 42 patients (21%) in the prospective studies discontinued MMF treatment because of toxicity. The area under the curve plasma concentrations of mycophenolic acid seemed to be suboptimal among patients with acute GVHD but not among those with chronic GVHD. MMF can be used effectively for treatment of GVHD.Bone Marrow Transplantation advance online publication, 20 April 2009; doi:10.1038/bmt.2009.76.

Item Type: Article
Additional Information: The link above directs to an Advance Online Publication version of this article.
DOI: 10.1038/bmt.2009.76
PubMed ID: 19377515
NIHMSID: NIHMS99533
PMCID: PMC2791193
Grant Numbers: CA18029, CA15704 , HL36444
Keywords or MeSH Headings: * Administration, Oral * Adolescent * Adult * Child * Child, Preschool * Female * Graft vs Host Disease/blood * Graft vs Host Disease/drug therapy* * Graft vs Host Disease/metabolism * Humans * Immunosuppressive Agents/blood * Immunosuppressive Agents/pharmacokinetics * Immunosuppressive Agents/therapeutic use* * Male * Middle Aged * Mycophenolic Acid/analogs & derivatives* * Mycophenolic Acid/blood * Mycophenolic Acid/pharmacokinetics * Mycophenolic Acid/therapeutic use * Prospective Studies * Retrospective Studies * Treatment Outcome * Young Adult
Subjects: Diseases > Graft vs Host
Therapeutics > Drug Therapy
Depositing User: Library Staff
Date Deposited: 14 Jul 2009 18:48
Last Modified: 14 Feb 2012 14:42
URI: http://authors.fhcrc.org/id/eprint/311

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