Therapy with mycophenolate mofetil for refractory acute and chronic GVHD

T. Furlong, P. Martin, M. E D Flowers, F. Carnevale-Schianca, R. Yatscoff, T. Chauncey, F. R. Appelbaum, H. J. Deeg, K. Doney, R. Witherspoon, B. Storer, K. M. Sullivan, R. Storb, R. A. Nash

Research output: Contribution to journalArticle

54 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)739-748
Number of pages10
JournalBone Marrow Transplantation
Volume44
Issue number11
DOIs
Publication statusPublished - Dec 21 2009

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Mycophenolic Acid
Prospective Studies
Immunosuppressive Agents
Therapeutics
Survival
Area Under Curve
Retrospective Studies
Pharmacokinetics
Incidence

Keywords

  • Acute and chronic GVHD
  • HSCT
  • MMF

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Furlong, T., Martin, P., Flowers, M. E. D., Carnevale-Schianca, F., Yatscoff, R., Chauncey, T., ... Nash, R. A. (2009). Therapy with mycophenolate mofetil for refractory acute and chronic GVHD. Bone Marrow Transplantation, 44(11), 739-748. https://doi.org/10.1038/bmt.2009.76

Therapy with mycophenolate mofetil for refractory acute and chronic GVHD. / Furlong, T.; Martin, P.; Flowers, M. E D; Carnevale-Schianca, F.; Yatscoff, R.; Chauncey, T.; Appelbaum, F. R.; Deeg, H. J.; Doney, K.; Witherspoon, R.; Storer, B.; Sullivan, K. M.; Storb, R.; Nash, R. A.

In: Bone Marrow Transplantation, Vol. 44, No. 11, 21.12.2009, p. 739-748.

Research output: Contribution to journalArticle

Furlong, T, Martin, P, Flowers, MED, Carnevale-Schianca, F, Yatscoff, R, Chauncey, T, Appelbaum, FR, Deeg, HJ, Doney, K, Witherspoon, R, Storer, B, Sullivan, KM, Storb, R & Nash, RA 2009, 'Therapy with mycophenolate mofetil for refractory acute and chronic GVHD', Bone Marrow Transplantation, vol. 44, no. 11, pp. 739-748. https://doi.org/10.1038/bmt.2009.76
Furlong, T. ; Martin, P. ; Flowers, M. E D ; Carnevale-Schianca, F. ; Yatscoff, R. ; Chauncey, T. ; Appelbaum, F. R. ; Deeg, H. J. ; Doney, K. ; Witherspoon, R. ; Storer, B. ; Sullivan, K. M. ; Storb, R. ; Nash, R. A. / Therapy with mycophenolate mofetil for refractory acute and chronic GVHD. In: Bone Marrow Transplantation. 2009 ; Vol. 44, No. 11. pp. 739-748.
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