Mycophenolate mofetil for the prophylaxis of acute GVHD in HLA-mismatched bone marrow transplant patients

Mycophenolate mofetil (MMF), a new immunosuppressive drug successfully used in renal and heart transplant recipients, was used in combination with cyc losporin A (CsA), methotrexate (MTX) and prednisolone for the prophylaxis o f acute graft-versus-host disease (aGVHD) after bone marrow transplantation (BMT) and peripheral blood stem cell transplantation (PBSCT) from human le ukocyte antigen (HLA)-mismatched, unrelated (n = 9) and related donors (n = 4) in an open single-centre phase II study. Thirteen patients, transplante d from HLA-mismatched donors of 18-57 yr of age, received 1 g MMF daily, st arting at day 10, in addition to CsA and prednisolone for aGVHD prophylaxis . All patients were engrafted between days 13 and 15. Four of the 13 patien ts experienced aGVHD grade I/II (n = 2) and grade III (n = 2). All patients except 3 were alive on day 100 post-transplantation. No severe adverse eff ects of MMF were recorded. In our pilot study, we demonstrated that MMF can be used safely for the prophylaxis of aGVHD.