Efficacy of mycophenolate mofetil in adult refractory auto‐immune cytopenias: a single center preliminary study
Identifieur interne : 001E76 ( Main/Exploration ); précédent : 001E75; suivant : 001E77Efficacy of mycophenolate mofetil in adult refractory auto‐immune cytopenias: a single center preliminary study
Auteurs : Rami Kotb [France] ; Caroline Pinganaud [France] ; Catherine Trichet [France] ; Olivier Lambotte [France] ; Marie Dreyfus [France] ; Jean-François Delfraissy [France] ; Gil Tchernia [France] ; Cécile Goujard [France]Source :
- European Journal of Haematology [ 0902-4441 ] ; 2005-07.
English descriptors
- Teeft :
- Adult patients, Aiha, Aitp, Aitp patients, Antinuclear antibodies, Cytopenia, Disease duration, Haemolytic anaemia, Hydroxychloroquine ivigg, Idiopathic, Idiopathic thrombocytopenic purpura, Immune, Immune thrombocytopenic purpura, Ivig, Ivigg, Kremlin france, Major response, Moderate response, Mofetil, Mycophenolate, Mycophenolate mofetil, Platelet, Platelet count, Platelet counts, Purpura, Refractory, Refractory cytopenias, Splenectomy, Steroid, Thrombocytopenic, Thrombocytopenic purpura.
Abstract
Abstract: Treatment of auto‐immune cytopenia refractory to front line therapy with intravenous immunoglobulins and steroids is a matter of concern. We assessed the efficacy and safety of mycophenolate mofetil in a prospective open preliminary study. Study design: Adult patients with steroid refractory auto‐immune cytopenias were included. Mycophenolate mofetil (MMF) was added to treatment given at the time of inclusion, and efficacy was evaluated in term of improvement of platelet/haemoglobin levels and in term of reduction of previously given drugs, if any. All auto‐immune thrombocytopenic purpura (AITP) patients had serologic assessment for associated auto‐antibodies at the time of inclusion. Cytopenias associated with other auto‐immune diseases, lymphoproliferative diseases or HIV infection were excluded. Results: From November 1999 through November 2003, 13 patients were included (nine AITP, three auto‐immune haemolytic anaemia (AIHA), one Evans’ syndrome; four males, nine females; age: 35–72 yr). For AITP patients, an overall response of 78% was observed. Retrospective analysis showed no significant difference between patients having a short disease duration (<1 yr) and longer disease duration; between patients who previously received more or less than three treatments; and between patients for whom MMF was started as monotherapy or in association with prednisone, However, all AITP patients presenting associated auto‐antibodies responded to MMF, while only 50% of patients without associated antibodies were responders. All patients presenting AIHA and Evans’ syndrome were responders. The drug was well tolerated, with no significant side effects reported. The cumulative data suggest a potential place for MMF in the treatment arsenal of refractory cytopenias.
Url:
DOI: 10.1111/j.1600-0609.2005.00437.x
Affiliations:
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Bicêtre</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">European Journal of Haematology</title><title level="j" type="alt">EUROPEAN JOURNAL OF HAEMATOLOGY</title><idno type="ISSN">0902-4441</idno><idno type="eISSN">1600-0609</idno><imprint><biblScope unit="vol">75</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="60">60</biblScope><biblScope unit="page" to="64">64</biblScope><biblScope unit="page-count">5</biblScope><publisher>Munksgaard International Publishers</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2005-07">2005-07</date></imprint><idno type="ISSN">0902-4441</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0902-4441</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Adult patients</term><term>Aiha</term><term>Aitp</term><term>Aitp patients</term><term>Antinuclear antibodies</term><term>Cytopenia</term><term>Disease duration</term><term>Haemolytic anaemia</term><term>Hydroxychloroquine ivigg</term><term>Idiopathic</term><term>Idiopathic thrombocytopenic purpura</term><term>Immune</term><term>Immune thrombocytopenic purpura</term><term>Ivig</term><term>Ivigg</term><term>Kremlin france</term><term>Major response</term><term>Moderate response</term><term>Mofetil</term><term>Mycophenolate</term><term>Mycophenolate mofetil</term><term>Platelet</term><term>Platelet count</term><term>Platelet counts</term><term>Purpura</term><term>Refractory</term><term>Refractory cytopenias</term><term>Splenectomy</term><term>Steroid</term><term>Thrombocytopenic</term><term>Thrombocytopenic purpura</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Treatment of auto‐immune cytopenia refractory to front line therapy with intravenous immunoglobulins and steroids is a matter of concern. We assessed the efficacy and safety of mycophenolate mofetil in a prospective open preliminary study. Study design: Adult patients with steroid refractory auto‐immune cytopenias were included. Mycophenolate mofetil (MMF) was added to treatment given at the time of inclusion, and efficacy was evaluated in term of improvement of platelet/haemoglobin levels and in term of reduction of previously given drugs, if any. All auto‐immune thrombocytopenic purpura (AITP) patients had serologic assessment for associated auto‐antibodies at the time of inclusion. Cytopenias associated with other auto‐immune diseases, lymphoproliferative diseases or HIV infection were excluded. Results: From November 1999 through November 2003, 13 patients were included (nine AITP, three auto‐immune haemolytic anaemia (AIHA), one Evans’ syndrome; four males, nine females; age: 35–72 yr). For AITP patients, an overall response of 78% was observed. Retrospective analysis showed no significant difference between patients having a short disease duration (<1 yr) and longer disease duration; between patients who previously received more or less than three treatments; and between patients for whom MMF was started as monotherapy or in association with prednisone, However, all AITP patients presenting associated auto‐antibodies responded to MMF, while only 50% of patients without associated antibodies were responders. All patients presenting AIHA and Evans’ syndrome were responders. The drug was well tolerated, with no significant side effects reported. The cumulative data suggest a potential place for MMF in the treatment arsenal of refractory cytopenias.</div></front></TEI><affiliations><list><country><li>France</li></country></list><tree><country name="France"><noRegion><name sortKey="Kotb, Rami" sort="Kotb, Rami" uniqKey="Kotb R" first="Rami" last="Kotb">Rami Kotb</name></noRegion><name sortKey="Delfraissy, Jean Rancois" sort="Delfraissy, Jean Rancois" uniqKey="Delfraissy J" first="Jean-François" last="Delfraissy">Jean-François Delfraissy</name><name sortKey="Dreyfus, Marie" sort="Dreyfus, Marie" uniqKey="Dreyfus M" first="Marie" last="Dreyfus">Marie Dreyfus</name><name sortKey="Goujard, Cecile" sort="Goujard, Cecile" uniqKey="Goujard C" first="Cécile" last="Goujard">Cécile Goujard</name><name sortKey="Lambotte, Olivier" sort="Lambotte, Olivier" uniqKey="Lambotte O" first="Olivier" last="Lambotte">Olivier Lambotte</name><name sortKey="Pinganaud, Caroline" sort="Pinganaud, Caroline" uniqKey="Pinganaud C" first="Caroline" last="Pinganaud">Caroline Pinganaud</name><name sortKey="Tchernia, Gil" sort="Tchernia, Gil" uniqKey="Tchernia G" first="Gil" last="Tchernia">Gil Tchernia</name><name sortKey="Trichet, Catherine" sort="Trichet, Catherine" uniqKey="Trichet C" first="Catherine" last="Trichet">Catherine Trichet</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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