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.

journal_name

Leuk Res

journal_title

Leukemia research

authors

Ram R,Yeshurun M,Vidal L,Shpilberg O,Gafter-Gvili A

doi

10.1016/j.leukres.2013.12.012

subject

Has Abstract

pub_date

2014-03-01 00:00:00

pages

352-60

issue

3

eissn

0145-2126

issn

1873-5835

pii

S0145-2126(13)00444-X

journal_volume

38

pub_type

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