The Effect of Mycophenolate Mofetil on Graft Versus Host Disease in Cyclosporine Induced Thrombotic Microangiopathy after Allogeneic Hematopoietic Stem Cell Transplantation

Calcineurin inhibitor induced thrombotic microangiopathy (TMA) is a serious complication in hematopoietic stem cell transplantation (HSCT). Mycophenolate mofetil (MMF) is a safe immunosuppressive drug that can be used for prophylaxis of primary graft versus host disease (GVHD) after developing TMA. In this study, our two patients received CellCept® after developing cyclosporine induced TMA. Acute GVHD (skin, oral and liver) was found in both patients, nevertheless, the GVHD was not severe and can be controlled with low dose prednisolone. Therefore, MMF is an optional immunosuppressant for GVHD prophylaxis in the transplant patient diagnosed with calcineurin or m-TOR inhibitors induced TMA.