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Title: Drug monitoring for mycophenolic acid in graft-vs-host disease prophylaxis in cord blood transplantation
Authors: Muranushi, Hiroyuki
Kanda, Junya  kyouindb  KAKEN_id  orcid (unconfirmed)
Arai, Yasuyuki  kyouindb  KAKEN_id  orcid (unconfirmed)
Shindo, Takero  kyouindb  KAKEN_id  orcid (unconfirmed)
Hishizawa, Masakatsu
Yamamoto, Takashi
Kondo, Tadakazu  kyouindb  KAKEN_id  orcid (unconfirmed)
Yamashita, Kohei
Matsubara, Kazuo
Takaori-Kondo, Akifumi
Author's alias: 諫田, 淳也
新井, 康之
進藤, 岳郎
菱澤, 方勝
山本, 崇
近藤, 忠一
松原, 和夫
髙折, 晃史
Keywords: cord blood transplantation
drug monitoring
mycophenolic acid
Issue Date: Dec-2020
Publisher: wiley
Journal title: British Journal of Clinical Pharmacology
Volume: 86
Issue: 12
Start page: 2464
End page: 2472
Abstract: [Aims] We performed the retrospective analysis to clarify the significance of drug monitoring for mycophenolic acid (MPA), the active form of mycophenolate mofetil (MMF), in prophylaxis for graft‐vs‐host disease (GVHD) in cord blood transplantation. [Methods] We retrospectively analysed the data of 46 patients who underwent first cord blood transplantation and received GVHD prophylaxis with tacrolimus plus MMF. MPA levels were measured on days 7 and 21, and 24‐hour areas under the curve (AUC0–24) were estimated. [Results] The engraftment and 3‐year overall survival rates of all patients were 94% and 78%, respectively. The cumulative incidence of sepsis before engraftment was higher in patients with AUC0–24 on day 7 of >60 μg h/mL than in other patients (33 vs 6%, P = .02). The cumulative incidence of grade II–IV acute GVHD was higher in patients with AUC0–24 on day 21 of ≤30 μg h/mL than in other patients (80 vs 50%, P = .04). The cumulative incidence of human herpesvirus 6 reactivation was higher in patients with AUC0–24 on day 21 of ≤48 μg h/mL (median) than in other patients (50 vs 19%, P = .03). [Conclusion Blood level of MPA was associated with risk of acute GVHD and infection. A prospective trial evaluating the benefit of personalized MMF dosing using MPA levels is needed.
Rights: This is the peer reviewed version of the following article: ['British Journal of Clinical Pharmacology', 86(12), 2464-2472], which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
The full-text file will be made open to the public on 30 May 2021 in accordance with publisher's 'Terms and Conditions for Self-Archiving'.
This is not the published version. Please cite only the published version.
DOI(Published Version): 10.1111/bcp.14354
PubMed ID: 32386102
Appears in Collections:Journal Articles

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