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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.
Afiliación
  • Kawashima N; Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan. kwnozomu@med.nagoya-u.ac.jp.
  • Iida M; Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. kwnozomu@med.nagoya-u.ac.jp.
  • Suzuki R; Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University School of Medicine, Nagakute, Japan.
  • Fukuda T; Department of Oncology and Hematology, Shimane University Hospital Innovative Cancer Center, Izumo, Japan.
  • Atsuta Y; Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
  • Hashii Y; Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.
  • Inoue M; Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan.
  • Kobayashi M; Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Izumi, Japan.
  • Yabe H; Department of Pediatrics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan.
  • Okada K; Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Isehara, Japan.
  • Adachi S; Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan.
  • Yuza Y; Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
  • Kawa K; Department of Hematology and Oncology, Tokyo Metropolitan Children's Medical Center, Fuchu, Japan.
  • Kato K; Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Izumi, Japan.
Int J Hematol ; 109(4): 491-498, 2019 Apr.
Article en En | MEDLINE | ID: mdl-30694451
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema de Registros / Trasplante de Células Madre Hematopoyéticas / Neoplasias Hematológicas / Enfermedad Injerto contra Huésped / Ácido Micofenólico Tipo de estudio: Clinical_trials Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: Asia Idioma: En Revista: Int J Hematol Asunto de la revista: HEMATOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema de Registros / Trasplante de Células Madre Hematopoyéticas / Neoplasias Hematológicas / Enfermedad Injerto contra Huésped / Ácido Micofenólico Tipo de estudio: Clinical_trials Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: Asia Idioma: En Revista: Int J Hematol Asunto de la revista: HEMATOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón