Graft-Versus-Host Disease
Bone Marrow Transplantation (2005) 35, 1089–1093. doi:10.1038/sj.bmt.1704956 Published online 11 April 2005
Cyclosporine A and Mycophenolate Mofetil vs Cyclosporine A and Methotrexate for graft-versus-host disease prophylaxis after stem cell transplantation from HLA-identical siblings
F Neumann1, T Graef1, C Tapprich1, M Vaupel1, U Steidl1, U Germing1, R Fenk1, A Hinke2, R Haas1 and G Kobbe1
- 1Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University, Duesseldorf, Germany, Moorenstr. 5, Duesseldorf, Germany
- 2Wissenschaftlicher Service Pharma Gmbh, WISP, Karl-Benz-Str. 1, Langenfeld, Germany
Correspondence: Dr F Neumann, Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University, Duesseldorf, Germany, Moorenstr. 5, 40225 Duesseldorf, Germany. E-mail: FTIMI@aol.com
Received 14 January 2005; Accepted 7 February 2005; Published online 11 April 2005.
Abstract
The combination of Cyclosporin A (CSA) and Methotrexate (MTX) is considered to be the standard regimen for the prevention of graft-versus-host disease (GVHD) after stem cell transplantation (SCT) from HLA-identical siblings. Mycophenolate Mofetil (MMF) has been widely used for GVHD prophylaxis after nonmyeloablative SCT, but experience following myeloablative therapy is still limited. We retrospectively compared CSA/MTX and CSA/MMF in 93 patients (median age 35 years, range 17–59 years, male subjects 48, female subjects 45) with acute myeloid leukemia (n=33), myelodysplastic syndrome (MDS) (n=3), acute lymphoblastic leukemia (ALL) (n=20) or chronic myeloid leukemia (n=37) who received CSA/MMF (n=26) or CSA/MTX (n=67) as GVHD prophylaxis following high-dose therapy and allogeneic SCT from HLA-identical siblings. No statistically significant differences were found in overall survival, relapse rate, treatment-related mortality and acute or chronic GVHD. Time to myeloid recovery was significantly shorter in patients who received CSA/MMF. We conclude that the combination of CSA/MMF appears equivalent to CSA/MTX for GVHD prophylaxis in patients receiving conventional-intensity SCT from HLA-identical siblings.
Keywords:
Methotrexate, Cyclosporine, Mycophenolate Mofetil, GVHD, stem cell transplantation
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