Evidence map›Paper›PMID 31158502›Full record

ArticleBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation2019

Inferior Outcomes with Cyclosporine and Mycophenolate Mofetil after Myeloablative Allogeneic Hematopoietic Cell Transplantation.

Betty K Hamilton, Ying Liu, Michael T Hemmer, Navneet Majhail, Olle Ringden, Dennis Kim, Luciano Costa, Robert Stuart, Amin Alousi, Joseph A Pidala and 29 more

Open access · greenAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
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  11. Updates in chronic graft-versus-host disease.Hematology. American Society of Hematology. Education Program · 2021
    Review
  12. 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

39 authors at 20 institutions in 8 countries.

Betty K HamiltonBlood and Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA. Electronic address: hamiltb2@ccf.org.
Ying LiuMedical College of Wisconsin, Milwaukee, Wisconsin, USA.
Michael T HemmerMedical College of Wisconsin, Milwaukee, Wisconsin, USA.
Navneet MajhailBlood and Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA.
Olle RingdenTranslational Cell Therapy Group, Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Dennis KimPrincess Margaret Cancer Center-BMT Program, Toronto, Ontario, Canada.
Luciano CostaDivision of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Robert StuartMedical University of South Carolina, Charleston, South Carolina, USA.
Amin AlousiDepartment of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Joseph A PidalaH. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Daniel R CourielUtah Blood and Marrow Transplant Program-Adults, Salt Lake City, Utah, USA.
Mahmoud AljurfDepartment of Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
Joseph H AntinDivision of Hematologic Malignancies, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Christopher BredesonThe Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Jean-Yves CahnDepartment of Hematology, CHU Grenoble Alpes, Grenoble, France.
Mitchell CairoDivision of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, Valhalla, New York.
Sung Won ChoiThe University of Michigan, Ann Arbor, Michigan, USA.
Christopher DandoyCincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Robert Peter GaleHematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom.
Usama GergisHematolgic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA.
Peiman HemattiDivision of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA.
Yoshihiro InamotoDivision of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
Rammurti T KambleDivision of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas, USA.
Margaret MacMillanUniversity of Minnesota Blood and Marrow Transplant Program-Pediatrics/Adults, Minneapolis, Minnesota, USA.
David I MarksAdult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom.
Eneida NemecekPediatric Blood & Marrow Transplant Program, Department of Pediatrics, Doernbecher Children's Hospital and Oregon Health & Science University, Portland, Oregon, USA.
Taiga NishihoriDepartment of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Ayman SaadDivision of Hematology, Ohio State University, Columbus, Ohio, USA.
Bipin N SavaniDivision of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Jeff SchriberCancer Transplant Institute, Virginia G. Piper Cancer Center, Scottsdale, Arizona, USA; Arizona Oncology, Scottsdale, Arizona, USA.
Sachiko SeoDepartment of Hematology and Oncology, Dokkyo Medical University, Mibu, Japan.
Gérard SociéDepartment of Hematology, Hopital Saint Louis, Paris, France.
Takanori TeshimaHokkaido University Hospital, Sapporo, Japan.
Leo F VerdonckDepartment of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands.
Edmund K WallerDepartment of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Mona WirkDivision of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington, USA.
Stephen R SpellmanCenter for International Blood and Marrow Transplant Research-Minneapolis, Minneapolis, Minnesota, USA.
Mukta AroraDivision of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota, USA.
Saurabh ChhabraCenter for International Blood and Marrow Transplant Research-Milwaukee, Milwaukee, Wisconsin, USA; Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Medical College of Wisconsin · USUniversity of Minnesota Medical Center · USCleveland Clinic · USMoffitt Cancer Center · USArizona Oncology · USBaylor College of Medicine · USCentre Hospitalier Universitaire de Grenoble · FRCincinnati Children's Hospital Medical Center · USDana-Farber Cancer Institute · USDoernbecher Children's Hospital · USDokkyo Medical University · JPEmory University · USFamilySearch · USHokkaido University Hospital · JPHôpital Saint-Louis · FRImperial College London · GBIsala · NLKarolinska Institutet · SEKing Faisal Specialist Hospital & Research Centre · SAMedical University of South Carolina · 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
NCI NIH HHS U24 CA076518
6 · The paper itself

Abstract

Combination therapy with a calcineurin inhibitor (CNI), such as cyclosporine (CSA) or tacrolimus (Tac), and methotrexate (MTX) or mycophenolate mofetil (MMF) is a widely used approach to graft-versus-host disease (GVHD) prevention. Data on the comparative effectiveness of MMF compared with MTX are limited and conflicting, however. We analyzed data from the Center for International Blood and Marrow Transplant Research for adult patients undergoing first myeloablative hematopoietic cell transplantation (HCT) from an HLA-identical matched related donor (MRD; n = 3979) or matched unrelated donor (URD; n = 4163) using CSA+MMF, CSA+MTX, Tac+MMF, or Tac+MTX for GVHD prevention between 2000 and 2013. Within the MRD cohort, 2252 patients received CSA+MTX, 1391 received Tac+MTX, 114 received CSA+MMF, and 222 received Tac+MMF. Recipients of CSA+MMF had a higher incidence of acute GVHD grade II-IV (hazard ratio [HR], 1.65; 95% confidence interval [CI], 1.24 to 2.20; P < .001) and grade III-IV (HR, 1.92; 95% CI, 1.31 to 2.83; P < .001) compared with Tac+MTX. The use of CSA+MMF was also associated with inferior overall survival (OS) (HR, 2.31; 95% CI, 1.73 to 3.09; P < .001) due to higher transplantation-related mortality (TRM) (HR, 4.03; 95% CI, 2.61 to 6.23; P < .001) compared with Tac+MTX. Within the URD cohort, 974 patients received CSA+MTX, 2697 received Tac+MTX, 68 received CSA+MMF, and 424 received Tac+MMF. CSA+MMF was again significantly associated with a higher incidence of grade III-IV acute GVHD (HR, 2.31; 95% CI, 1.57 to 3.42; P <0001), worse OS (HR, 2.36; 95% CI, 1.67 to 3.35; P < .001), and higher TRM (HR, 3.09; 95% CI, 2.00 to 4.77; P < .001), compared with Tac+MTX and other regimens. Thus, this large retrospective comparison of MMF versus MTX in combination with CSA or Tac demonstrates significantly worse GVHD and survival outcomes with CSA+MMF compared with Tac+MTX.

Indexed as

Graft vs Host DiseaseHematopoietic Stem Cell TransplantationAdolescentAdultAgedAllograftsCyclosporineDisease-Free SurvivalFemaleHumansMaleMiddle AgedMycophenolic AcidSurvival RateCyclosporineMycophenolic AcidAllogeneic hematopoietic cell transplantationGraft-versus-host diseaseMethotrexateMycophenolate mofetilMyeloablative

Identifiers

PMID31158502
PMCPMC7039394
OpenAlexW2947159089

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Registered trials

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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.