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Post-Transplant Events

Valganciclovir is safe and effective as pre-emptive therapy for CMV infection in allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 37, pages 851–856 (2006)Cite this article

Abstract

Despite significant advances in prevention and therapy, cytomegalovirus (CMV) infection continues to be an important cause of morbidity and mortality in the hematopoietic stem cell transplant (HSCT) recipient. The standard drug for pre-emptive therapy is intravenous ganciclovir (GCV). Valganciclovir (VGC), the oral pro-drug of GCV, has excellent bioavailability and is ideal for oral therapy. Since March 2002, VGC was adopted in our center for outpatient pre-emptive therapy in all patients undergoing allogeneic HSCT. Fifty-two allogeneic HSCT recipients were followed weekly via Digene hybrid capture assay®. Patients with a positive assay were treated with VGC 900 mg p.o. b.i.d. × 14 days followed by 900 mg p.o. QD until at least 7 days after a negative test. Eighteen patients (14 sib, four MUD) had 30 episodes of CMV DNA detection treated with oral VGC. Median duration of therapy was 21 days (range 10–21 days). The rate of response was 93% (28/30) as confirmed by a negative assay within 14 days. No significant toxicity was encountered. Two patients failed oral VGC. One case of CMV enteritis was diagnosed in a patient with acute GVHD. Pre-emptive therapy of CMV infection with oral VGC is safe and effective in allogeneic HSCT recipients.

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Acknowledgements

We thank all the clinicians, nurses, and pharmacists from our transplantation team who helped to take care of this group of patients.

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Authors and Affiliations

  1. H Lee Moffitt Cancer Center, Tampa, FL, USA

    E Ayala, J Greene, R Sandin, J Perkins, T Field & C Tate

  2. University of Texas at San Antonio, San Antonio, TX, USA

    K K Fields

  3. University of Pennsylvania, Philadelphia, PA, USA

    S Goldstein

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  1. E Ayala
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Correspondence to E Ayala.

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Ayala, E., Greene, J., Sandin, R. et al. Valganciclovir is safe and effective as pre-emptive therapy for CMV infection in allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 37, 851–856 (2006). https://doi.org/10.1038/sj.bmt.1705341

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