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December 8, 2025BloodOpen Access

MMF is associated with higher non-relapse mortality and inferior survival in AML/MDS patients receiving peripheral blood matched allogeneic stem cell transplantation with post-transplant cyclophosphamide based gvhd prophylaxis

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Authors

RSRima M. SalibaGRGabriela RondónAAAmin Alousi

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Overview

Observational cohort shows MMF increases non-relapse mortality and reduces overall survival in AML/MDS patients undergoing stem cell transplantation, indicating safety concerns.

Key Points

  • To assess the impact of mycophenolate mofetil on outcomes in AML/MDS patients post-hematopoietic cell transplantation.
  • Conducted a single-center cohort analysis of AML/MDS patients receiving first HLA-matched HCT with peripheral blood stem cells.
  • Evaluated outcomes in patients receiving post-transplant cyclophosphamide-based GvHD prophylaxis, with or without MMF.
  • Used univariate and multivariate analyses to account for competing risks.
  • Out of 846 patients, MMF was linked to inferior overall survival (53% vs 65%) and increased non-relapse mortality (20% vs 13%) for patients with higher comorbidity burden.
  • Acute and chronic graft-versus-host disease rates did not significantly differ by MMF use.
  • Bacterial infections were noted as a common cause of non-relapse mortality among patients receiving MMF.

Cite This Study

Saliba et al. (2025) studied this question.

synapsesocial.com/papers/69362f5a4fa91c937236dbb8https://doi.org/10.1182/blood-2025-5996
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prospective Clinical Trial of Mycophenolate Mofetil (MMF) Duration De-Escalation in Allogeneic Hematopoietic Cell Transplantation (HCT) for Inborn Errors of Immunity: Is MMF Dispensable After Reduced Intensity Conditioning, Posttransplantation Cyclophosphamide(Ptcy)-Based HCT?2026
  2. 2Effect of post-transplant cyclophosphamide on outcomes in stem cell transplant recipients with myelofibrosis2025
  3. 3Mismatched unrelated and haploidentical transplant with post-transplant cyclophosphamide-based graft versus host disease prophylaxis are effective for myelofibrosis2025
  4. 4Fludarabine and total body irradiation 800 cgy or 1125 cgy for allogeneic stem cell transplant using graft versus host disease prophylaxis with post-transplant cyclophosphamide and tacrolimus, without mycophenolate mofetil (OmitMMF trial)2025
  5. 5Outcomes after bone marrow versus peripheral blood mismatched unrelated donor hematopoietic cell transplantation using posttransplant cyclophosphamide-based GVHD prophylaxis2025