International Journal of Hematology

, Volume 92, Issue 2, pp 351–359

Use of foscarnet for cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation from a related donor

  • Maiko Asakura
  • Kazuhiro Ikegame
  • Satoshi Yoshihara
  • Shuichi Taniguchi
  • Takehiko Mori
  • Tetsuya Etoh
  • Akiyoshi Takami
  • Takashi Yoshida
  • Takahiro Fukuda
  • Kazuo Hatanaka
  • Heiwa Kanamori
  • Toshiaki Yujiri
  • Yoshiko Atsuta
  • Hisashi Sakamaki
  • Ritsuro Suzuki
  • Hiroyasu Ogawa
Original Article

DOI: 10.1007/s12185-010-0657-y

Cite this article as:
Asakura, M., Ikegame, K., Yoshihara, S. et al. Int J Hematol (2010) 92: 351. doi:10.1007/s12185-010-0657-y

Abstract

Foscarnet is an active agent against cytomegalovirus (CMV) infection after hematopoietic stem cell transplantation (HSCT), as well as ganciclovir. We investigated the usefulness of foscarnet in patients who underwent related allogeneic HSCT. Foscarnet was used in 320 patients with a median age of 45 years (range 15–72). The purpose of administration was CMV disease in 65, preemptive use in 248 and prophylaxis in 7. Totally, 194 patients had a history of prior ganciclovir treatment. The reason for foscarnet use was insufficient therapeutic effect of prior ganciclovir in 99, and adverse event including myelosuppression in 95. The response rate in symptom was 52% for the CMV disease patients. Antigenemia disappeared in 77% of the preemptive treatment and improved in 13% of the patients. No outbreak of CMV disease was recognized. The total effectiveness of therapeutic and preemptive use was significantly higher for patients without prior ganciclovir (91 vs. 76%, P = 0.001). Adverse events of grade 3 or higher were recognized in 24%, including electrolyte abnormalities in 11%, neutropenia in 8%, and thrombocytopenia in 8%. Renal damage was only observed in 3% of patients. Foscarnet was concluded to be a safe and effective anti-CMV agent and to be a suitable alternative to ganciclovir.

Keywords

Cytomegalovirus infectionFoscarnetBlood and marrow transplantationEfficacyAdverse reaction

Copyright information

© The Japanese Society of Hematology 2010

Authors and Affiliations

  • Maiko Asakura
    • 1
  • Kazuhiro Ikegame
    • 2
  • Satoshi Yoshihara
    • 2
  • Shuichi Taniguchi
    • 3
  • Takehiko Mori
    • 4
  • Tetsuya Etoh
    • 5
  • Akiyoshi Takami
    • 6
  • Takashi Yoshida
    • 7
  • Takahiro Fukuda
    • 8
  • Kazuo Hatanaka
    • 9
  • Heiwa Kanamori
    • 10
  • Toshiaki Yujiri
    • 11
  • Yoshiko Atsuta
    • 1
  • Hisashi Sakamaki
    • 12
  • Ritsuro Suzuki
    • 1
  • Hiroyasu Ogawa
    • 2
  1. 1.Department of HSCT Data Management and BiostatisticsNagoya University School of MedicineNagoyaJapan
  2. 2.Division of Hematology, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
  3. 3.Department of HematologyToranomon HospitalTokyoJapan
  4. 4.Division of Hematology, Department of MedicineKeio University School of MedicineTokyoJapan
  5. 5.Department of HematologyHamanomachi HospitalFukuokaJapan
  6. 6.Department of Cellular Transplantation BiologyKanazawa University Graduate School of MedicineKanazawaJapan
  7. 7.Hematology DepartmentToyama Prefectural HospitalToyamaJapan
  8. 8.Hematopoietic Stem Cell Transplantation DivisionNational Cancer Center HospitalTokyoJapan
  9. 9.Department of Internal MedicineRinku General Medical CenterIzumisanoJapan
  10. 10.Department of HematologyKanagawa Cancer CenterYokohamaJapan
  11. 11.Third Department of Internal MedicineYamaguchi University School of MedicineUbeJapan
  12. 12.Department of HematologyTokyo Metropolitan Komagome HospitalTokyoJapan