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International Journal of Hematology

, Volume 91, Issue 5, pp 886–891 | Cite as

A randomized trial of preemptive therapy for prevention of cytomegalovirus disease after allogeneic hematopoietic stem cell transplantation

  • Seung Tae Kim
  • Mark H. LeeEmail author
  • Sung Yong Kim
  • Seok Jin Kim
  • Dong Hwan Kim
  • Jun Ho Jang
  • Kihyun Kim
  • Won Seog Kim
  • Chul Won Jung
Original Article

Abstract

We studied the efficacy of two different doses of ganciclovir to prevent cytomegalovirus (CMV) disease in allogeneic hematopoietic stem cell transplantation (HSCT) recipients. We randomly assigned allogeneic HSCT recipients who had CMV infection to receive preemptive ganciclovir therapy with or without induction phase (5 mg/kg twice daily for 1 week). Thirty-two and thirty-six patients were randomized to the standard and the low-dose therapy group, respectively. The median time to CMV antigenemia or viremia clearance was 7 days (3–25 days) in the standard therapy group versus 11 days (3–69 days) in the low-dose therapy group (P = 0.540). The incidence of CMV disease was similar between the two groups (P = 0.366). The Kaplan–Meier estimate of event-free survival by day 180 after HSCT was 76.2% in the standard therapy group versus 66.7% in the low-dose therapy group (P = 0.590). Severe neutropenia (<0.5 × 109/L) was observed in four (12.5%) patients in the standard therapy group versus two (5.6%) patients in the low-dose therapy group (P = 0.314). This study suggests that a low-dose ganciclovir preemptive therapy can be as effective as the standard-dose ganciclovir preemptive therapy for the prevention of CMV disease in allogeneic HSCT recipients.

Keywords

Cytomegalovirus infection Hematopoietic stem cell transplantation Preemptive therapy Ganciclovir 

Notes

Acknowledgments

This paper was supported by Konkuk University in 2008. We would like to thank Dr. Sun Woo Kim for statistical assistance and Dr. Nam Yong Lee for performing the CMV assays.

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Copyright information

© The Japanese Society of Hematology 2010

Authors and Affiliations

  • Seung Tae Kim
    • 1
  • Mark H. Lee
    • 3
    Email author
  • Sung Yong Kim
    • 3
  • Seok Jin Kim
    • 2
  • Dong Hwan Kim
    • 2
  • Jun Ho Jang
    • 2
  • Kihyun Kim
    • 2
  • Won Seog Kim
    • 2
  • Chul Won Jung
    • 2
  1. 1.Division of Hematology-Oncology, Department of Medicine, Korea University Anam HospitalKorea University College of MedicineSeoulKorea
  2. 2.Division of Hematology-Oncology, Department of Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea
  3. 3.Division of Hematology/Oncology, Department of Internal Medicine, Konkuk University Medical CenterKonkuk University School of MedicineSeoulKorea

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