Effect of mycophenolate mofetil on hematological side effects incidence in renal transplant recipients.
Study Goal
The researchers aimed to assess the relationship between mycophenolate mofetil (MMF) metabolites and hematopoietic adverse effects, including iron-related outcomes, in renal transplant recipients.
Results Summary
The study found that anemia was more frequent in MMF-treated patients, with higher plasma iron concentrations observed, but iron supplementation was ineffective in patients with declined renal function. MPAG pharmacokinetic parameters negatively correlated with hemoglobin and hematocrit, suggesting MPAG may predict MMF-induced anemia.
Population
Renal transplant recipients in the late post-transplant period (n = 61 MMF-treated patients out of 106 total participants).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mycophenolate mofetil (MMF) | increase | hematological toxicity | solid organ transplantation patients | - | frequently causes | #1 |
Mycophenolate mofetil (MMF) | increase | anemia | renal transplant recipients | 30.7% vs. 20.0% | more frequently observed | #2 |
Mycophenolate mofetil (MMF) | increase | plasma iron concentrations | patients treated with MMF | 32.9 ± 9.4 μmol/L vs. 28.7 ± 9.4 μmol/L | significantly higher | #3 |
iron supplementation | increase | anemia | patients with anemia | 48.2% vs. 20.3% | more frequently applied | #4 |
MPAG pharmacokinetic parameters | decrease | hemoglobin | renal transplant recipients | - | correlated negatively | #5 |
MPAG pharmacokinetic parameters | decrease | hematocrit | renal transplant recipients | - | correlated negatively | #6 |
MPAG pharmacokinetic parameters | increase | anemia | patients with anemia | - | higher | #7 |
extensive iron supplementation | no change | anemia | renal transplant recipients with deteriorated renal function | - | may be ineffective | #8 |
declined renal function | increase | anemia | renal transplant recipients | - | associated with | #9 |
Mycophenolate mofetil (MMF), an immunosuppressant administered after solid organ transplantation, is generally well tolerated; however, it frequently causes hematological toxicity. In this study, we aimed to assess the relation between the pharmacokinetic parameters of MMF metabolites (mycophenolic acid [MPA] and 7-O-MPA glucuronide [MPAG]) and the adverse effects on the hematopoietic system in renal transplant recipients. The four-h pharmacokinetic profiles of MPA and MPAG were determined using the HPLC method for MMF-treated patients (n = 61) among 106 renal transplant recipients (during the late post-transplant period) participating in the study. Anemia was more frequently observed in the study group compared with the control group (30.7% vs. 20.0%) and although the difference was insignificant, plasma iron concentrations were significantly higher in patients treated with MMF (32.9 ± 9.4 μmol/L vs. 28.7 ± 9.4 μmol/L; p = 0.032). Iron supplementation was more frequently applied to patients with anemia (48.2%) compared with patients with hemoglobin within the norm (20.3%; p = 0.005). As all MPAG pharmacokinetic parameters correlated negatively with hemoglobin and hematocrit, and MPAG pharmacokinetic parameters were higher in patients with anemia, MPAG may be the predicting factor of MMF side effects. In renal transplant recipients, especially with deteriorated renal function, extensive iron supplementation may be ineffective as anemia was associated with declined renal function and was not caused by low iron concentration.