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Valacyclovir for the prevention of cytomegalovirus infection after allogeneic stem cell transplantation: a single institution retrospective cohort analysis.
Bone Marrow Transplant. 2001 Aug; 28(3):265-70.BM

Abstract

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+Show Affiliations

Division of Hematology and Oncology, Department of Medicine, Vanderbilt University School of Medicine and VA Medical Center, Nashville, TN 37212, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11535994

Citation

Vusirikala, M, et al. "Valacyclovir for the Prevention of Cytomegalovirus Infection After Allogeneic Stem Cell Transplantation: a Single Institution Retrospective Cohort Analysis." Bone Marrow Transplantation, vol. 28, no. 3, 2001, pp. 265-70.
Vusirikala M, Wolff SN, Stein RS, et al. Valacyclovir for the prevention of cytomegalovirus infection after allogeneic stem cell transplantation: a single institution retrospective cohort analysis. Bone Marrow Transplant. 2001;28(3):265-70.
Vusirikala, M., Wolff, S. N., Stein, R. S., Brandt, S. J., Morgan, D. S., Greer, J. P., Schuening, F. G., Dummer, J. S., & Goodman, S. A. (2001). Valacyclovir for the prevention of cytomegalovirus infection after allogeneic stem cell transplantation: a single institution retrospective cohort analysis. Bone Marrow Transplantation, 28(3), 265-70.
Vusirikala M, et al. Valacyclovir for the Prevention of Cytomegalovirus Infection After Allogeneic Stem Cell Transplantation: a Single Institution Retrospective Cohort Analysis. Bone Marrow Transplant. 2001;28(3):265-70. PubMed PMID: 11535994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Valacyclovir for the prevention of cytomegalovirus infection after allogeneic stem cell transplantation: a single institution retrospective cohort analysis. AU - Vusirikala,M, AU - Wolff,S N, AU - Stein,R S, AU - Brandt,S J, AU - Morgan,D S, AU - Greer,J P, AU - Schuening,F G, AU - Dummer,J S, AU - Goodman,S A, PY - 2000/12/18/received PY - 2001/05/16/accepted PY - 2001/9/6/pubmed PY - 2002/3/8/medline PY - 2001/9/6/entrez SP - 265 EP - 70 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 28 IS - 3 N2 - 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. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/11535994/Valacyclovir_for_the_prevention_of_cytomegalovirus_infection_after_allogeneic_stem_cell_transplantation:_a_single_institution_retrospective_cohort_analysis_ L2 - https://doi.org/10.1038/sj.bmt.1703129 DB - PRIME DP - Unbound Medicine ER -