Low-dose short-course intravenous ganciclovir as pre-emptive therapy for CMV viremia post allo-PBSC transplantation

R. Vij, H. Khoury, R. Brown, L. T. Goodnough, S. M. Devine, W. Blum, D. Adkins, J. F. DiPersio

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

In contrast to allogeneic bone marrow transplantation (allo-BMT), there is a paucity of data on cytomegalovirus (CMV) infection and pre-emptive therapy (PT) strategies following allogeneic peripheral blood stem cell (allo-PBSC) transplantation. We report here on the patterns of CMV infection in a cohort of 225 patients following sibling donor allo-PBSC transplantation. In an attempt to reduce neutropenia, we used intravenous low-dose short-course (LDSC) ganciclovir (GCV) 5 mg/kg once daily for 21 days as preemptive therapy. A total of 165 recipient-donor pairs were CMV seropositive. An initial episode of viremia (detected by shell vial/tube culture) occurred in 75/165 (45%) at a median of day + 35 (17-445) post allo-PBSC. In all, 58 patients received PT with LDSC GCV. Among 58, 55 (94%) completed the 21-day course of PT. A second episode of viremia occurred in 19/58 (33%) at day + 80 (50-174) and a third episode in 5/58 (9%) at day + 134 (103-218). Among patients receiving LDSC GCV, 5/58(9%) developed disease (four pneumonia, one colitis) at day + 211 (63-487). No patient on LDSC GCV exhibited a decline in their ANC below 500/μl and none required growth factors. LDSC GCV is extremely well tolerated and cost-effective as PT or CMV viremia following allo-PBSC transplantation.

Original languageEnglish
Pages (from-to)703-707
Number of pages5
JournalBone Marrow Transplantation
Volume32
Issue number7
DOIs
StatePublished - Oct 1 2003

Keywords

  • Allo-PBSC transplant
  • Cytomegalovirus
  • Ganciclovir
  • Pre-emptive therapy

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