Evidence map›Paper›PMID 19925875›Full record

Trial reportBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation2010

Mycophenolate pharmacokinetics and association with response to acute graft-versus-host disease treatment from the Blood and Marrow Transplant Clinical Trials Network.

Pamala A Jacobson, Jiayin Huang, Juan Wu, Miae Kim, Brent Logan, Amin Alousi, Michael Grimley, Javier Bolaños-Meade, Vincent Ho, John E Levine and 1 more

Registry-linked trialOpen access · greenAbstract readClinical Trial, Phase IIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00224874 (Initial Systemic Treatment of Acute GVHD), which is not on this map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
0.5field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00224874 phase2completednot on this map

Initial Systemic Treatment of Acute GVHD: A Phase II Randomized Trial Evaluating Etanercept, Mycophenolate Mofetil (MMF), Denileukin Diftitox (ONTAK), and Pentostatin in Combination With Corticosteroids (BMT CTN #0302)

TypeinterventionalSponsorNational Heart, Lung, and Blood Institute (NHLBI)Ran2005 to 2012Enrolled180ConditionsGraft vs Host Disease, Immune System DisordersArmsEtanercept, Mycophenolate Mofetil, Denileukin Diftitox, Pentostatin
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 34 citations in OpenAlex.

  1. Combination Therapy for Graft-versus-Host Disease Prophylaxis with Etanercept and Extracorporeal Photopheresis: Results of a Phase II Clinical Trial.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2016
    Trial
  2. Intensified Mycophenolate Mofetil Dosing and Higher Mycophenolic Acid Trough Levels Reduce Severe Acute Graft-versus-Host Disease after Double-Unit Cord Blood Transplantation.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2015
    Trial
  3. Trial
  4. Trial
  5. Article
  6. Review
  7. Inferior Outcomes with Cyclosporine and Mycophenolate Mofetil after Myeloablative Allogeneic Hematopoietic Cell Transplantation.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2019
    Article
  8. Inosine Monophosphate Dehydrogenase Pharmacogenetics in Hematopoietic Cell Transplantation Patients.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2018
    Article
  9. Review
  10. The Blood and Marrow Transplant Clinical Trials Network: An Effective Infrastructure for Addressing Important Issues in Hematopoietic Cell Transplantation.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2016
    Review
  11. Review
  12. Review
  13. Article
  14. Article
  15. Nonrelapse mortality and mycophenolic acid exposure in nonmyeloablative hematopoietic cell transplantation.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2013
    Article
  16. Graft-versus-host disease after double-unit cord blood transplantation has unique features and an association with engrafting unit-to-recipient HLA match.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2013
    Article
  17. A novel reduced-intensity conditioning regimen induces a high incidence of sustained donor-derived neutrophil and platelet engraftment after double-unit cord blood transplantation.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2013
    Article
  18. Graft-versus-host disease: state of the science.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2013
    Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 2 countries.

Pamala A JacobsonExperimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 308 Harvard Street SE, Minneapolis, MN 55455, USA. jacob117@umn.edu
Jiayin Huang
Juan Wu
Miae Kim
Brent Logan
Amin Alousi
Michael Grimley
Javier Bolaños-Meade
Vincent Ho
John E Levine
Daniel Weisdorf
University of Minnesota · USAlkermes (Ireland) · IECHRISTUS Transplant Institute · USDana-Farber Cancer Institute · USJohns Hopkins University · USMedical College of Wisconsin · USThe University of Texas MD Anderson Cancer Center · USUniversity of Michigan–Ann Arbor · US

Funding

Data Resource for Analyzing Blood &Marrow TransplantsU24CA076518 · NCI · MEDICAL COLLEGE OF WISCONSIN · PI Amy M Moskop, Bronwen Shaw · 1998 to 2026
$105.2M
Easy-to-read Informed Consent for HCT Clinical TrialsU10HL069294 · NHLBI · MEDICAL COLLEGE OF WISCONSIN · PI HOROWITZ, MARY MARESCA · 2011 to 2016
$43.8M
A Randomized Trial of Tac/MTX/bortezomib vs Tac/MTXplacebo in Allogeneic HSCTU10HL069249 · NHLBI · DANA-FARBER CANCER INST · PI ANTIN, JOSEPH H · 2011 to 2016
$1.1M
University of Michigan Core Clinical Center for BMT Research NetworkU10HL069330 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI YANIK, GREGORY A · 2011 to 2016
$959k
Enhancing the Safety of Allogeneic TransplantationU10HL069290 · NHLBI · UNIVERSITY OF MINNESOTA · PI WEISDORF, DANIEL J · 2011 to 2016
$931k
Core Clinical Consortium for Blood and Marrow Transplant Clinical Trials NetworkU10HL069301 · NHLBI · UNIVERSITY OF FLORIDA · PI WINGARD, JOHN R. · 2011 to 2016
$882k
Optimizing Stem Cell Transplant for CancerK23CA096622 · NCI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI JACOBSON, PAMALA A · 2002 to 2006
$610k
NCI NIH HHS K23 CA096622NCI NIH HHS U24 CA076518NHLBI NIH HHS U10 HL069249NHLBI NIH HHS U10 HL069290NHLBI NIH HHS U10 HL069294NHLBI NIH HHS U10 HL069301NHLBI NIH HHS U10 HL069330
6 · The paper itself

Abstract

There are limited data as to the effectiveness of mycophenolate mofetil (MMF) plus high-dose corticosteroids for the treatment of acute graft-versus-host disease (aGVHD), and even less data regarding the pharmacokinetic disposition and exposure-response relationship of MMF in individuals with GVHD. MMF pharmacokinetics were studied in a multicenter Blood and Marrow Transplant Clinical Trials Network randomized phase II trial evaluating the effectiveness of MMF as one of 4 agents added to corticosteroids as treatment of aGVHD. Thirty-two of the patients randomized to receive MMF underwent pharmacokinetic sampling in weeks 1 and 2 were studied. Mean age was 41 +/- 13.6 years. Twenty one (65.6%), 5 (15.6%), 6 (18.8%) patients had a complete response (CR), partial response (PR) or lesser response by day 28, respectively. Twenty-five (78.1%), 2 (6.3%), 5 (15.6%) patients had a CR, PR, or other response by day 56 to treatment, respectively. Mycophenolic acid (MPA) pharmacokinetic measurements from weeks 1 and 2 did not correlate with CR at either day 28 or day 56 (P > .07); however, if the mean of weeks 1 and 2 total MPA troughs was >0.5 microg/mL or that of an unbound trough was >0.015 microg/mL, then a significantly greater proportion achieved CR + PR at days 28 and 56. CR + PR at day 28 was observed in 19 of 19 patients (100%) with a mean total trough >0.5 mg/mL, but in only 7 of 13 (54%) with a mean total trough < or =0.5 microg/mL (P = .002). Similarly, CR + PR at day 28 was seen in 15 of 15 patients (100%) with an unbound trough concentration >0.015 microg/mL, but in only 11 of 17 (65%) with an unbound trough concentration < or =0.015 microg/mL (P = .02). There was no association between the pharmacokinetic measures and risk of infection by day 90 or overall survival (OS) at day 180 postrandomization. About one-half of subjects did not achieve the favorable MPA total and unbound trough concentrations. The current practice of MMF 1 gm twice daily dosing provides low plasma concentrations in many patients. Higher doses may improve the efficacy of MMF as aGVHD therapy.

Indexed as

Adrenal Cortex HormonesAdultArea Under CurveCommunicable DiseasesDrug Therapy, CombinationGlucuronidesGraft vs Host DiseaseHumansImmunosuppressive AgentsLiverLower Gastrointestinal TractMiddle AgedMycophenolic AcidRemission InductionSkinSurvival AnalysisAdrenal Cortex HormonesGlucuronidesImmunosuppressive AgentsMycophenolic Acidmycophenolic acid glucuronide

Identifiers

PMID19925875
PMCPMC3104501
OpenAlexW2104138182

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.