Initial low-dose valganciclovir as a preemptive therapy is effective for cytomegalovirus infection in allogeneic hematopoietic stem cell transplant recipients

Preemptive therapy for cytomegalovirus (CMV) infection in allogeneic hematopoietic stem cell transplant (HSCT) patients is effective in decreasing the incidence of CMV disease. Intravenous ganciclovir is a commonly used preemptive therapy, but as we have recently shown, oral valganciclovir (VGC) is...

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Bibliographic Details
Published in:International journal of hematology 2012-07, Vol.96 (1), p.94-100
Main Authors: Takenaka, Katsuto, Nagafuji, Koji, Takase, Ken, Kamimura, Tomohiko, Mori, Yasuo, Ito, Yoshikiyo, Nishi, Yukiko, Henzan, Hideho, Kato, Koji, Harada, Naoki, Eto, Tetsuya, Miyamoto, Toshihiro, Teshima, Takanori, Akashi, Koichi
Format: Article
Language:English
Subjects:
Adult
Aged
Antibiotic Prophylaxis - adverse effects
Antiviral Agents - administration & dosage
Antiviral Agents - adverse effects
Biological and medical sciences
Cytomegalovirus Infections - drug therapy
Cytomegalovirus Infections - prevention & control
Cytomegalovirus Infections - virology
Ganciclovir - administration & dosage
Ganciclovir - adverse effects
Ganciclovir - analogs & derivatives
Hematologic and hematopoietic diseases
Hematology
Hematopoietic Stem Cell Transplantation
Humans
Infectious diseases
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Oncology
Original Article
Transplantation, Homologous
Treatment Outcome
Viral diseases
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Summary:Preemptive therapy for cytomegalovirus (CMV) infection in allogeneic hematopoietic stem cell transplant (HSCT) patients is effective in decreasing the incidence of CMV disease. Intravenous ganciclovir is a commonly used preemptive therapy, but as we have recently shown, oral valganciclovir (VGC) is a useful alternative. However, the optimal dose of VGC has not been determined. We prospectively evaluated the efficacy and toxicity of an initial low-dose of VGC (900 mg QD) as preemptive therapy in 20 patients with low-level CMV antigenemia following allogeneic HSCT. Patients were screened weekly for CMV pp65 antigenemia after engraftment. Preemptive therapy with VGC (900 mg QD) was initiated if more than two CMV antigen-positive cells per 50,000 leukocytes were detected. CMV antigen-positive cells disappeared from all 20 patients after 14–29 days (median 20 days) of VGC treatment. None of the patients developed CMV disease nor did they require more than the conventional VGC dose (900 mg BID). Neutropenia (
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-012-1087-9