Abstract
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 antigenpositive 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 (<500/lL) developed in three patients who required granulocyte- colony-stimulating factor support, but there were no other significant side effects. These observations suggest that the initial dose of VGC in preemptive therapy forCMVcan be safely decreased to 900 mg QD for patients with low-level CMV antigenemia.
| Original language | English |
|---|---|
| Pages (from-to) | 94-100 |
| Number of pages | 7 |
| Journal | International journal of hematology |
| Volume | 96 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jul 1 2012 |
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All Science Journal Classification (ASJC) codes
- Hematology
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Initial low-dose valganciclovir as a preemptive therapy is effective for cytomegalovirus infection in allogeneic hematopoietic stem cell transplant recipients. / 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.
In: International journal of hematology, Vol. 96, No. 1, 01.07.2012, p. 94-100.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Initial low-dose valganciclovir as a preemptive therapy is effective for cytomegalovirus infection in allogeneic hematopoietic stem cell transplant recipients
AU - Takenaka, Katsuto
AU - Nagafuji, Koji
AU - Takase, Ken
AU - Kamimura, Tomohiko
AU - Mori, Yasuo
AU - Ito, Yoshikiyo
AU - Nishi, Yukiko
AU - Henzan, Hideho
AU - Kato, Koji
AU - Harada, Naoki
AU - Eto, Tetsuya
AU - Miyamoto, Toshihiro
AU - Teshima, Takanori
AU - Akashi, Koichi
PY - 2012/7/1
Y1 - 2012/7/1
N2 - 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 antigenpositive 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 (<500/lL) developed in three patients who required granulocyte- colony-stimulating factor support, but there were no other significant side effects. These observations suggest that the initial dose of VGC in preemptive therapy forCMVcan be safely decreased to 900 mg QD for patients with low-level CMV antigenemia.
AB - 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 antigenpositive 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 (<500/lL) developed in three patients who required granulocyte- colony-stimulating factor support, but there were no other significant side effects. These observations suggest that the initial dose of VGC in preemptive therapy forCMVcan be safely decreased to 900 mg QD for patients with low-level CMV antigenemia.
UR - http://www.scopus.com/inward/record.url?scp=84864991620&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84864991620&partnerID=8YFLogxK
U2 - 10.1007/s12185-012-1087-9
DO - 10.1007/s12185-012-1087-9
M3 - Article
C2 - 22547196
AN - SCOPUS:84864991620
VL - 96
SP - 94
EP - 100
JO - International Journal of Hematology
JF - International Journal of Hematology
SN - 0925-5710
IS - 1
ER -