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

doi:10.1016/j.leukres.2013.12.012

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 journal › Article › peer-review

31 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 language	English
Pages (from-to)	352-360
Number of pages	9
Journal	Leukemia Research
Volume	38
Issue number	3
DOIs	https://doi.org/10.1016/j.leukres.2013.12.012
State	Published - Mar 2014
Externally published	Yes

Keywords

Allogeneic transplantation
Graft-versus-host disease
Methotrexate
Mycopheolate

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10.1016/j.leukres.2013.12.012

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

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.",

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author = "Ron Ram and Moshe Yeshurun and Liat Vidal and Ofer Shpilberg and Anat Gafter-Gvili",

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KW - Allogeneic transplantation

KW - Graft-versus-host disease

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

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Keywords

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