Phase I-II Trial of Foscarnet for Prevention of Cytomegalovirus Infection in Autologous and Allogeneic Marrow Transplant Recipients

The safety and efficacy of foscarnet for prevention of cytomegalovirus (CMV) infection was evaluated in 19 CMV-seropositive bone marrow transplant (BMT) recipients. All patients received intermittent intravenous (iv) foscarnet: 40 mg/kg every 8 h from 7 days before to day 30 after BMT, then 60 mg/kg...

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Bibliographic Details
Published in:The Journal of infectious diseases 1992-09, Vol.166 (3), p.473-479
Main Authors: Reusser, Pierre, Gambertoglio, John G., Lilleby, Kathy, Meyers, Joel D.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antiviral Agents - adverse effects
Antiviral Agents - pharmacokinetics
Antiviral Agents - therapeutic use
Autologous transplantation
Blood
Bone marrow
Bone Marrow Transplantation
Cytomegalovirus
Cytomegalovirus infections
Cytomegalovirus Infections - prevention & control
Dosage
Drug Evaluation
Female
Foscarnet
Homologous transplantation
Humans
Infections
Kidney - drug effects
Major Articles
Male
Middle Aged
Phosphonoacetic Acid - adverse effects
Phosphonoacetic Acid - analogs & derivatives
Phosphonoacetic Acid - pharmacokinetics
Phosphonoacetic Acid - therapeutic use
Preventive medicine
Prospective Studies
Transplantation
Transplantation, Autologous
Transplantation, Homologous
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Summary:The safety and efficacy of foscarnet for prevention of cytomegalovirus (CMV) infection was evaluated in 19 CMV-seropositive bone marrow transplant (BMT) recipients. All patients received intermittent intravenous (iv) foscarnet: 40 mg/kg every 8 h from 7 days before to day 30 after BMT, then 60 mg/kg once a day until day 75. The main toxicity was transient renal dysfunction, with a >50 µmol/L increase in serum creatinine above baseline in 5 of the 7 autograft recipients and in 6 of the 12 allograft recipients. Only 4 allograft recipients developed CMV infection during foscarnet prophylaxis, and no patient showed evidenceofCMV disease. Because 3 allograft recipients receiving concomitant iv amphotericin B showed rapid impairment of renal function, foscarnet prophylaxis should not be given to allograft recipients requiring amphotericin B; otherwise, foscarnet prophylaxis at this dose appears safe after BMT.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/166.3.473