TY - JOUR
T1 - Cyclosporine A and Mycophenolate Mofetil vs Cyclosporine A and Methotrexate for graft-versus-host disease prophylaxis after stem cell transplantation from HLA-identical siblings
AU - Neumann, F.
AU - Graef, T.
AU - Tapprich, C.
AU - Vaupel, M.
AU - Steidl, U.
AU - Germing, U.
AU - Fenk, R.
AU - Hinke, A.
AU - Haas, R.
AU - Kobbe, G.
PY - 2005/6
Y1 - 2005/6
N2 - 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.
AB - 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.
KW - Cyclosporine
KW - GVHD
KW - Methotrexate
KW - Mycophenolate Mofetil
KW - Stem cell transplantation
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UR - http://www.scopus.com/inward/citedby.url?scp=20044386782&partnerID=8YFLogxK
U2 - 10.1038/sj.bmt.1704956
DO - 10.1038/sj.bmt.1704956
M3 - Article
C2 - 15821769
AN - SCOPUS:20044386782
SN - 0268-3369
VL - 35
SP - 1089
EP - 1093
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 11
ER -