Enteric‐coated mycophenolate sodium containing GvHD prophylaxis reduces GvHD rate after allogeneic HSCT. (14th January 2016) - Weber, Thomas
Abstract: Objectives: The aim of this study was to evaluate whether cyclosporine A (CsA)‐based Graft vs. Host Disease (GvHD) prophylaxis with enteric‐coated mycophenolate sodium (EC‐MPS) instead of mycophenolate mofetil (MMF) or methotrexate (MTX) reduces the GvHD incidence and lowers gastrointestinal (GI‐) toxicities. Methods: In a retrospective analysis of 102 allogeneic hematopoietic stem cell transplant (HSCT) patients, incidences of overall and severe aGvHD (>II°), cGvHD as well as overall and severe (CTC >II°) GI‐toxicities were compared between GvHD prophylaxis containing EC‐MPS vs. MMF or MTX (control group). Results: The overall aGvHD rate was significantly lower in the EC‐MPS group compared to the control (47% vs. 72%, P = 0.022) with lower rates of severe aGvHD (10% vs. 25%, P = 0.088) and cGvHD (20% vs. 39%, P = 0.065). Prophylaxis with EC‐MPS remained significantly associated with a lower aGvHD rate in a multiple logistic regression model. GI‐toxicities did not differ between both groups except for severe abdominal pain for which the incidence was increased in the EC‐MPS group (17% vs. 3%, P = 0.022). Conclusions: This data support the hypothesis that replacement of MMF or MTX by EC‐MPS reduces GvHD rates after HSCT. This appears not to be due to a reduced GI‐toxicity of EC‐MPS.