{"doi":"10.1016/j.jtct.2020.10.016","title":"Long-term Outcomes with Nonmyeloablative HLA-Identical Related Hematopoietic Cell Transplantation Using Tacrolimus and Mycophenolate Mofetil for Graft-versus-Host Disease Prophylaxis","abstract":"ABSTRACT Nonmyeloablative allogeneic hematopoietic cell transplantation (HCT) from HLA-identical related donors using cyclosporine (CSP) and mycophenolate mofetil (MMF) for postgrafting immunosuppression is effective therapy for hematologic cancers. However, graft-versus-host-disease (GVHD) remains a major cause of morbidity and mortality. Pilot data suggested lower acute GVHD incidence with tacrolimus/MMF compared to historical experience using CSP/MMF after nonmyeloablative HCT. In a phase II multicenter trial, we evaluated the effect of tacrolimus/MMF for GVHD prophylaxis after HLA-identical related donor peripheral blood HCT in patients with hematologic malignancies (n = 150) using conditioning with 2 Gy total body irradiation (TBI) for patients with a preceding (within 6 months) planned autologous HCT (n = 50) or combined with 90 mg/m 2 fludarabine for those without recent autologous HCT (n = 100). Oral tacrolimus was given from days –3 to 56 (tapered by day +180 if no GVHD). Oral MMF was given from days 0 to 27. Patient median age was 57 (range, 20 to 74) years. The cumulative incidences (CI) of day 100 grade II to IV and III to IV acute GVHD were 27% and 4%, respectively. With median follow-up of 10.3 (range, 3.1 to 14.5) years, the 5-year CI of chronic extensive GVHD was 48%. One-year and 5-year estimates of nonrelapse mortality, relapse/progression, survival, and progression-free survival were 9% and 13%, 35% and 50%, 73% and 53%, and 56% and 37%, respectively. GVHD prophylaxis with tacrolimus/MMF resulted in a low risk of acute GVHD and compared favorably with results from a concurrent trial using CSP/MMF. A randomized phase III trial to investigate tacrolimus/MMF versus CSP/MMF in nonmyeloablative HCT is warranted.","journal":"Transplantation and Cellular Therapy","year":2020,"id":117133,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9527,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":393373,"name":"Barry E. Storer","orcid":"0000-0003-1565-435X","position":1,"is_corresponding":false},{"id":546662,"name":"Huiying Qiu","orcid":"0000-0001-5211-725X","position":2,"is_corresponding":false},{"id":393374,"name":"Thomas R. Chauncey","orcid":"0000-0003-2815-7301","position":3,"is_corresponding":false},{"id":467808,"name":"Julie Asch","orcid":"0000-0001-9465-9778","position":4,"is_corresponding":false},{"id":547274,"name":"Michael W. Boyer","orcid":null,"position":5,"is_corresponding":false},{"id":459216,"name":"Luisa Giaccone","orcid":"0000-0002-0860-3266","position":6,"is_corresponding":false},{"id":326533,"name":"Mary E.D. Flowers","orcid":"0000-0003-1631-0911","position":7,"is_corresponding":false},{"id":236729,"name":"Marco Mielcarek","orcid":"0000-0002-5680-8688","position":8,"is_corresponding":false},{"id":236734,"name":"Rainer Storb","orcid":"0000-0002-9343-4099","position":9,"is_corresponding":false},{"id":232698,"name":"David G. Maloney","orcid":"0000-0002-8477-6919","position":10,"is_corresponding":false},{"id":236728,"name":"Brenda M. Sandmaier","orcid":"0000-0002-9767-9739","position":11,"is_corresponding":false},{"id":547273,"name":"Masumi Ueda Oshima","orcid":null,"position":0,"is_corresponding":true}],"reference_count":23,"raw_metadata":null,"created_at":"2026-07-18T23:13:51.309289Z","pmid":"33830025","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}