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Infections Post Transplant

Cidofovir as primary pre-emptive therapy for post-transplant cytomegalovirus infections

Bone Marrow Transplantation volume 28, pages 879–881 (2001)Cite this article

Abstract

Pre-emptive antiviral therapy for CMV infection following allogeneic stem cell transplantation is an effective strategy for preventing CMV disease. This entails the logistic difficulty of daily intravenous therapy with ganciclovir or foscarnet to clinically asymtomatic patients. Cidofovir (CDV) is effective against CMV in vitro and has the practical advantage of weekly administration. However, there are limited data on the pre-emptive use of CDV in CMV infections. We carried out a pilot study exploring the efficacy and toxicity of CDV as primary pre-emptive therapy for CMV infections monitored by PCR-based assays. CDV was used at 5 mg/kg with probenecid and hydration, weekly for a maximum of 4 weeks, followed by fortnightly maintenance treatment. Four patients were treated with CDV and two of them responded. Both the non-responders developed CMV disease. There was no renal toxicity noted in any of the patients, but three patients had severe vomiting and one developed uveitis, which precluded maintenance treatment in the two responders. Following failure of CDV, foscarnet was effective in controlling the CMV infection in both patients, although the infection recurred in both. Thus, larger randomised studies are required before CDV can be recommended as a primary pre-emptive therapy for post-transplant CMV infections. Bone Marrow Transplantation (2001) 28, 879–881.

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References

  1. Avery RK, Adal KA, Longworth DL, Bolwell BJ . A survey of allogeneic bone marrow transplant programs in the United States regarding cytomegalovirus prophylaxis and pre-emptive therapy Bone Marrow Transplant 2000 26: 763–767

    Article  CAS  PubMed  Google Scholar 

  2. Reusser P, Einsele H, Lee J et al. Randomised, multicenter, open-label trial of foscarnet versus ganciclovir for preemptive therapy of cytomegalovirus infection after allogeneic stem cell transplantation (abstract) ICAAC: San Francisco 1999

    Google Scholar 

  3. Ljungman P, Deliliers GL, Platzbecker U et al. Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients Blood 2001 97: 388–392

    Article  CAS  PubMed  Google Scholar 

  4. Zhou L, Harder TC, Ullmann U, Rautenberg P . Rapid detection by reverse hybridization of mutations in the UL97 gene of human cytomegalovirus conferring resistance to ganciclovir J Clin Virol 1999 13: 53–59

    Article  CAS  PubMed  Google Scholar 

  5. Tong CY, Cuevas L, Williams H, Bakran A . Use of laboratory assays to predict cytomegalovirus disease in renal transplant recipients J Clin Microbiol 1998 36: 2681–2685

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Flexman J, Kay I, Fonte R et al. Differences between the quantitative antigenemia assay and the cobas amplicor monitor quantitative PCR assay for detecting CMV viraemia in bone marrow and solid organ transplant patients J Med Virol 2001 64: 275–282

    Article  CAS  PubMed  Google Scholar 

  7. Chakrabarti S, Pillay D, Ratcliffe D et al. Resistance to antiviral drugs in herpes simplex virus infections among allogeneic stem cell transplant recipients: risk factors and prognostic significance J Infect Dis 2000 181: 2055–2058

    Article  CAS  PubMed  Google Scholar 

  8. Held TK, Biel SS, Nitsche A et al. Treatment of BK virus-associated hemorrhagic cystitis and simultaneous CMV reactivation with cidofovir Bone Marrow Transplant 2000 26: 347–350

    Article  CAS  PubMed  Google Scholar 

  9. Castagnola E, Cristina E, Dallorso S et al. Failure of cidofovir to reduce CMV-antigenemia in a child transplanted from a matched unrelated donor J Chemother 2001 13: 100–101

    Article  CAS  PubMed  Google Scholar 

  10. Long-term follow-up of patients with AIDS treated with parenteral cidofovir for cytomegalovirus retinitis: the HPMPC Peripheral Cytomegalovirus Retinitis Trial . The Studies of Ocular Complications of AIDS Research Group in collaboration with the AIDS Clinical Trials Group AIDS 2000 14: 1571–1581

    Article  Google Scholar 

  11. Erice A . Resistance of human cytomegalovirus to antiviral drugs Clin Microbiol Rev 1999 12: 286–297

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Haematology, Birmingham Heartlands Hospital, Birmingham, UK

    S Chakrabarti, CD Fegan & DW Milligan

  2. Public Health Laboratories, Birmingham Heartlands Hospital, Birmingham, UK

    KE Collingham & H Osman

Authors
  1. S Chakrabarti
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  2. KE Collingham
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  3. H Osman
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  4. CD Fegan
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  5. DW Milligan
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Chakrabarti, S., Collingham, K., Osman, H. et al. Cidofovir as primary pre-emptive therapy for post-transplant cytomegalovirus infections. Bone Marrow Transplant 28, 879–881 (2001). https://doi.org/10.1038/sj.bmt.1703251

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  • DOI: https://doi.org/10.1038/sj.bmt.1703251

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