New strategies in GVHD prophylaxis

Despite immunosuppressive therapy using cyclosporine (CsA) and prednisolone and methotrexate (MTX), the incidence for aGVHD grade II to IV after trans plantation from HLA matched unrelated donors (MUD) is 78%, the incidence fo r grade III and IV 36%, Since GVHD contributes to morbidity and mortality a fter MUD-BMT, a more effective prophylactic regimen is needed in order to p revent these transplant-associated complications. Recently, we described th at mycophenolate mofetil (MMF, CellCept), an immunosuppressive agent succes sfully used for the prevention of acute rejection in renal allograft recipi ents, can safely and effectively be used for the treatment of aGVHD in hema topoietic stem cell transplantation. Information on the i,v, formulation of mycophenolic acid (MPA) is not yet available, Here we report on the i,v, f ormulation of MMF in hematopoietic stem cell recipients. MMF is effective i n the prophylaxis of acute GVHD after stem cell transplantation; the optima l dosage needs further investigation. At the present time the relevance of measurement of plasma MPA concentrations on MMF dosage is not yet understoo d and further evaluation is required.