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Graft-versus-Host Disease

Combination of CsA, MTX and low-dose, short-course mycophenolate mofetil for GVHD prophylaxis

Bone Marrow Transplantation volume 43, pages 61–67 (2009)Cite this article

Abstract

In an effort to reduce the incidence and severity of acute GVHD (aGVHD), we have developed a new prophylaxis regimen combining cyclosporine and MTX with a short 30-day course of low-dose (500 mg per day) mycophenolate mofetil. This regimen was studied prospectively 100 patients undergoing HLA-matched and 1-antigen-mismatched allogeneic peripheral blood SCT from related donors. The cumulative incidence of aGVHD was 16% (grades II–IV (9.5%) and grades III–IV (1%)). The cumulative incidence of chronic GVHD (cGVHD) was 53% with 28% extensive cGVHD. The cumulative incidence of transplant-related mortality at 100 days and 3 years were 6 and 13%. The estimated probabilities of disease-free survival at 3 years in standard- and high-risk patients were 77 and 30%, respectively (P<0.0001). The estimated probabilities of overall survival at 3 years in standard- and high-risk patients were 77 and 37%, respectively (P<0.0001). These data show a substantial decrease in the risk of developing aGVHD without an increase in relapse or any adverse impact on survival in standard-risk patients.

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Acknowledgements

We thank Delong Liu, MD, PhD, (New York Medical College, USA) for critically reviewing the paper and his important advice in science and in English. We also thank Dr Xiaodong Zhu, Dr Dang Wang And Dr Rensheng Wang who has participated in this study. We thank every faculty member who has participated in this study.

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Authors and Affiliations

  1. Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China

    Y Lai, J Ma, Z Cai, J Zhou, Z Peng, J Yang, L Luo, J Luo, D Deng, Q Li, Y Zhou & J Liang

  2. Southern Cancer Center, Mobile, AL, USA

    P Schwarzenberger

  3. Department of Pathology, University of Texas Medical School at Houston, Houston, TX, USA

    W Li

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Correspondence to Y Lai.

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Lai, Y., Ma, J., Schwarzenberger, P. et al. Combination of CsA, MTX and low-dose, short-course mycophenolate mofetil for GVHD prophylaxis. Bone Marrow Transplant 43, 61–67 (2009). https://doi.org/10.1038/bmt.2008.265

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