Document Detail


Valacyclovir for the prevention of cytomegalovirus infection after allogeneic stem cell transplantation: a single institution retrospective cohort analysis.
MedLine Citation:
PMID:  11535994     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A retrospective single center study was performed to evaluate the safety and efficacy of valacyclovir for prevention of cytomegalovirus (CMV) infection (reactivation) after allogeneic stem cell transplantation (SCT). We compared a group of 31 patients at risk for CMV reactivation (donor, recipient or both seropositive for CMV) who received valacyclovir at an oral dose of 1 g three times a day for CMV prophylaxis with a matched cohort of 31 patients who did not receive the drug or any other form of CMV prophylaxis. Valacyclovir was used as primary prophylaxis in 12 patients and as secondary prophylaxis (after a prior CMV reactivation was effectively treated with either ganciclovir or foscarnet and without CMV antigenemia at the start of valacyclovir) in the remaining 19 patients. The two treatment groups were well matched for the donor-recipient CMV serological status and other pre-transplant characteristics. CMV reactivation was detected by blood antigenemia testing using a commercially available immunofluorescence assay for CMV lower matrix protein pp65 in circulating leukocytes. For primary prophylaxis, 3/12 patients who received valacyclovir reactivated CMV compared to 24/31 patients in the control group (P < 0.001). For secondary prophylaxis, 5/19 valacyclovir patients reactivated compared to 16/24 control patients (P < 0.05). Valacyclovir was well tolerated except for infrequent and mild gastrointestinal side-effects. There was no difference in the incidence of CMV disease in the two groups. Prophylaxis with valacyclovir appears to be safe and efficacious in preventing both primary and secondary CMV reactivation in at-risk patients after allogeneic SCT. Larger prospective randomized studies will be required to confirm these observations.
Authors:
M Vusirikala; S N Wolff; R S Stein; S J Brandt; D S Morgan; J P Greer; F G Schuening; J S Dummer; S A Goodman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bone marrow transplantation     Volume:  28     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-09-05     Completed Date:  2002-03-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  265-70     Citation Subset:  IM    
Affiliation:
Division of Hematology and Oncology, Department of Medicine, Vanderbilt University School of Medicine and VA Medical Center, Nashville, TN 37212, USA.
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MeSH Terms
Descriptor/Qualifier:
Acyclovir / administration & dosage*,  analogs & derivatives*,  toxicity
Adult
Antiviral Agents / administration & dosage,  toxicity
Cohort Studies
Consumer Product Safety
Cytomegalovirus Infections / chemically induced,  drug therapy,  prevention & control*
Female
Hematopoietic Stem Cell Transplantation / adverse effects*
Humans
Male
Middle Aged
Phosphoproteins / blood
Retrospective Studies
Therapeutic Equivalency
Transplantation, Homologous / adverse effects
Valine / administration & dosage*,  analogs & derivatives*,  toxicity
Viral Matrix Proteins / blood
Virus Activation / drug effects
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/Phosphoproteins; 0/Viral Matrix Proteins; 0/cytomegalovirus matrix protein 65kDa; 124832-27-5/valacyclovir; 59277-89-3/Acyclovir; 7004-03-7/Valine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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