1. ¹Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University, Duesseldorf, Germany, Moorenstr. 5, Duesseldorf, Germany
2. 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.