Abstract
We investigated the safety and efficacy of mycophenolate mofetil (MMF) in the prevention and treatment of graft-versus-host disease (GVHD) using a nationwide retrospective survey in Japanese children undergoing hematopoietic stem cell transplantation (HSCT). Overall, 141 children undergoing allogeneic HSCT for hematological malignancy (n = 84), non-malignancy (n = 52), and solid tumors (n = 5) were administered MMF orally (median 8 years; range 0–15 years; 89 males and 52 females) during 1995–2011. Donors were primarily unrelated and mismatched related. In the GVHD prophylaxis group, 29% and 8.6% of patients developed grade II–IV and III–IV GVHD, respectively. Of the 32 evaluable patients, 16% developed chronic [limited (n = 4) and extensive (n = 1)] GVHD. In the acute GVHD treatment group, 61% had decreased grade. In the chronic GVHD treatment group, 36% had improved symptoms. Combined immunosuppressant was reduced or discontinued in 61% patients. Major adverse events (AEs) were neutropenia (4.3%), infection (3.5%), thrombocytopenia (2.1%), myelosuppression (2.1%), and diarrhea (1.4%). MMF dosage was reduced in two children due to grade ≥ 3 AEs; two children died from infection. MMF thus may be well tolerated in children, and may be an effective option for prophylaxis and treatment of acute and chronic GVHD.
| Original language | English |
|---|---|
| Pages (from-to) | 491-498 |
| Number of pages | 8 |
| Journal | International journal of hematology |
| Volume | 109 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 5 2019 |
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All Science Journal Classification (ASJC) codes
- Hematology
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Prophylaxis and treatment with mycophenolate mofetil in children with graft-versus-host disease undergoing allogeneic hematopoietic stem cell transplantation : a nationwide survey in Japan. / Kawashima, Nozomu; Iida, Minako; Suzuki, Ritsuro; Fukuda, Takahiro; Atsuta, Yoshiko; Hashii, Yoshiko; Inoue, Masami; Kobayashi, Masao; Yabe, Hiromasa; Okada, Keiko; Adachi, Souichi; Yuza, Yuki; Kawa, Keisei; Kato, Koji.
In: International journal of hematology, Vol. 109, No. 4, 05.04.2019, p. 491-498.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prophylaxis and treatment with mycophenolate mofetil in children with graft-versus-host disease undergoing allogeneic hematopoietic stem cell transplantation
T2 - a nationwide survey in Japan
AU - Kawashima, Nozomu
AU - Iida, Minako
AU - Suzuki, Ritsuro
AU - Fukuda, Takahiro
AU - Atsuta, Yoshiko
AU - Hashii, Yoshiko
AU - Inoue, Masami
AU - Kobayashi, Masao
AU - Yabe, Hiromasa
AU - Okada, Keiko
AU - Adachi, Souichi
AU - Yuza, Yuki
AU - Kawa, Keisei
AU - Kato, Koji
PY - 2019/4/5
Y1 - 2019/4/5
N2 - We investigated the safety and efficacy of mycophenolate mofetil (MMF) in the prevention and treatment of graft-versus-host disease (GVHD) using a nationwide retrospective survey in Japanese children undergoing hematopoietic stem cell transplantation (HSCT). Overall, 141 children undergoing allogeneic HSCT for hematological malignancy (n = 84), non-malignancy (n = 52), and solid tumors (n = 5) were administered MMF orally (median 8 years; range 0–15 years; 89 males and 52 females) during 1995–2011. Donors were primarily unrelated and mismatched related. In the GVHD prophylaxis group, 29% and 8.6% of patients developed grade II–IV and III–IV GVHD, respectively. Of the 32 evaluable patients, 16% developed chronic [limited (n = 4) and extensive (n = 1)] GVHD. In the acute GVHD treatment group, 61% had decreased grade. In the chronic GVHD treatment group, 36% had improved symptoms. Combined immunosuppressant was reduced or discontinued in 61% patients. Major adverse events (AEs) were neutropenia (4.3%), infection (3.5%), thrombocytopenia (2.1%), myelosuppression (2.1%), and diarrhea (1.4%). MMF dosage was reduced in two children due to grade ≥ 3 AEs; two children died from infection. MMF thus may be well tolerated in children, and may be an effective option for prophylaxis and treatment of acute and chronic GVHD.
AB - We investigated the safety and efficacy of mycophenolate mofetil (MMF) in the prevention and treatment of graft-versus-host disease (GVHD) using a nationwide retrospective survey in Japanese children undergoing hematopoietic stem cell transplantation (HSCT). Overall, 141 children undergoing allogeneic HSCT for hematological malignancy (n = 84), non-malignancy (n = 52), and solid tumors (n = 5) were administered MMF orally (median 8 years; range 0–15 years; 89 males and 52 females) during 1995–2011. Donors were primarily unrelated and mismatched related. In the GVHD prophylaxis group, 29% and 8.6% of patients developed grade II–IV and III–IV GVHD, respectively. Of the 32 evaluable patients, 16% developed chronic [limited (n = 4) and extensive (n = 1)] GVHD. In the acute GVHD treatment group, 61% had decreased grade. In the chronic GVHD treatment group, 36% had improved symptoms. Combined immunosuppressant was reduced or discontinued in 61% patients. Major adverse events (AEs) were neutropenia (4.3%), infection (3.5%), thrombocytopenia (2.1%), myelosuppression (2.1%), and diarrhea (1.4%). MMF dosage was reduced in two children due to grade ≥ 3 AEs; two children died from infection. MMF thus may be well tolerated in children, and may be an effective option for prophylaxis and treatment of acute and chronic GVHD.
UR - http://www.scopus.com/inward/record.url?scp=85063904659&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063904659&partnerID=8YFLogxK
U2 - 10.1007/s12185-019-02601-5
DO - 10.1007/s12185-019-02601-5
M3 - Article
C2 - 30694451
AN - SCOPUS:85063904659
VL - 109
SP - 491
EP - 498
JO - International Journal of Hematology
JF - International Journal of Hematology
SN - 0925-5710
IS - 4
ER -