International Journal of Hematology

, Volume 89, Issue 2, pp 231–237

Oral valganciclovir as preemptive therapy is effective for cytomegalovirus infection in allogeneic hematopoietic stem cell transplant recipients

  • Katsuto Takenaka
  • Tetsuya Eto
  • Koji Nagafuji
  • Kenjiro Kamezaki
  • Yayoi Matsuo
  • Goichi Yoshimoto
  • Naoki Harada
  • Maki Yoshida
  • Hideho Henzan
  • Ken Takase
  • Toshihiro Miyamoto
  • Koichi Akashi
  • Mine Harada
  • Takanori Teshima
  • for Fukuoka Blood and Marrow Transplant Group (FBMTG)
Original Article

DOI: 10.1007/s12185-008-0249-2

Cite this article as:
Takenaka, K., Eto, T., Nagafuji, K. et al. Int J Hematol (2009) 89: 231. doi:10.1007/s12185-008-0249-2

Abstract

Between March 2007 and January 2008, the safety and efficacy of oral valganciclovir (VGC) preemptive therapy for cytomegalovirus (CMV) infection was evaluated in ten consecutive patients who received allogeneic hematopoietic stem cell transplantation (HSCT). Patients were screened once or twice per week after engraftment using CMV pp65 antigenemia assay. When more than 2 CMV antigen-positive cells per 50,000 leukocytes were detected, preemptive therapy with oral VGC was initiated at a dose of 900 mg twice daily for 3 weeks. Nine patients (90%) completed the 3-week VGC treatment except for one patient who developed febrile neutropenia. There was no other significant toxicity. CMV antigen-positive cells were rapidly decreased in all nine patients and became undetectable by the end of the VGC treatment. None of the patients developed CMV disease. CMV infection relapsed in four of the ten patients (40%) after the VGC treatment. These observations suggest that preemptive therapy with VGC is effective for preventing CMV disease in allogeneic HSCT patients. Further studies with a large number of patients will be necessary to determine the optimal initial- and maintenance-dose of VGC.

Keywords

Allogeneic hematopoietic stem cell transplantation Cytomegalovirus infection Preemptive therapy Valganciclovir 

Copyright information

© The Japanese Society of Hematology 2009

Authors and Affiliations

  • Katsuto Takenaka
    • 1
  • Tetsuya Eto
    • 2
  • Koji Nagafuji
    • 1
  • Kenjiro Kamezaki
    • 1
  • Yayoi Matsuo
    • 2
  • Goichi Yoshimoto
    • 1
  • Naoki Harada
    • 1
  • Maki Yoshida
    • 2
  • Hideho Henzan
    • 2
  • Ken Takase
    • 2
  • Toshihiro Miyamoto
    • 3
  • Koichi Akashi
    • 1
  • Mine Harada
    • 1
    • 4
  • Takanori Teshima
    • 3
  • for Fukuoka Blood and Marrow Transplant Group (FBMTG)
  1. 1.Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical SciencesFukuokaJapan
  2. 2.Department of HematologyHamanomachi General HospitalFukuokaJapan
  3. 3.Center for Cellular and Molecular MedicineKyushu University HospitalFukuokaJapan
  4. 4.Department of Internal MedicineNational Hospital Organization Omuta National HospitalOmutaJapan