Mycophenolate mofetil vs. methotrexate for the prevention of graft-versus-host-disease - Systematic review and meta-analysis

Ron Ram, Moshe Yeshurun, Liat Vidal, Ofer Shpilberg, Anat Gafter-Gvili

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

We performed a systematic review and meta-analysis of all trials comparing MMF and methotrexate as GVHD prophylaxis. Our search yielded 11 studies; 3 were randomized-control trials (RCTs). While the incidence of grades 2-4 acute GVHD was comparable, the incidence of grades 3 and 4 acute GVHD was higher in patients given MMF (RR 1.61; 95% CI 1.18-2.30). Incidence of mucositis was lower (RR 0.35; 95% CI 0.25-0.49) and time to engraftment was shorter (mean difference (-3.6); 95% CI -5.5 to -1.7) in patients given MMF. All other analyzed transplantation outcomes were comparable. We conclude that MMF, compared to methotrexate, is associated with increased severity of acute GVHD. Robustness of these results is hampered by the small number of RCTs.

Original languageEnglish
Pages (from-to)352-360
Number of pages9
JournalLeukemia Research
Volume38
Issue number3
DOIs
StatePublished - 1 Mar 2014
Externally publishedYes

Keywords

  • Allogeneic transplantation
  • Graft-versus-host disease
  • Methotrexate
  • Mycopheolate

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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