Enteric‐coated mycophenolate sodium containing Gv HD prophylaxis reduces Gv HD rate after allogeneic HSCT

Objectives The aim of this study was to evaluate whether cyclosporine A (CsA)‐based Graft vs. Host Disease (Gv HD ) prophylaxis with enteric‐coated mycophenolate sodium ( EC ‐ MPS ) instead of mycophenolate mofetil ( MMF ) or methotrexate ( MTX ) reduces the Gv HD incidence and lowers gastrointestinal ( GI ‐) toxicities. Methods In a retrospective analysis of 102 allogeneic hematopoietic stem cell transplant ( HSCT ) patients, incidences of overall and severe aGvHD (>II°), cGvHD as well as overall and severe (CTC >II°) GI ‐toxicities were compared between Gv HD prophylaxis containing EC ‐ MPS vs. MMF or MTX (control group). Results The overall aGvHD rate was significantly lower in the EC ‐ MPS group compared to the control (47% vs. 72%, P = 0.022) with lower rates of severe aGvHD (10% vs. 25%, P = 0.088) and cGvHD (20% vs. 39%, P = 0.065). Prophylaxis with EC ‐ MPS remained significantly associated with a lower aGvHD rate in a multiple logistic regression model. GI ‐toxicities did not differ between both groups except for severe abdominal pain for which the incidence was increased in the EC ‐ MPS group (17% vs. 3%, P = 0.022). Conclusions This data support the hypothesis that replacement of MMF or MTX by EC ‐ MPS reduces Gv HD rates after HSCT . This appears not to be due to a reduced GI ‐toxicity of EC ‐ MPS .