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

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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.

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Authors and Affiliations

  1. Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Katsuto Takenaka, Koji Nagafuji, Kenjiro Kamezaki, Goichi Yoshimoto, Naoki Harada, Koichi Akashi & Mine Harada

  2. Department of Hematology, Hamanomachi General Hospital, Fukuoka, Japan

    Tetsuya Eto, Yayoi Matsuo, Maki Yoshida, Hideho Henzan & Ken Takase

  3. Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan

    Toshihiro Miyamoto & Takanori Teshima

  4. Department of Internal Medicine, National Hospital Organization Omuta National Hospital, Omuta, Japan

    Mine Harada

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  1. Katsuto Takenaka
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  2. Tetsuya Eto
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  14. Takanori Teshima
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for Fukuoka Blood and Marrow Transplant Group (FBMTG)

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Correspondence to Katsuto Takenaka.

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Takenaka, K., Eto, T., Nagafuji, K. et al. Oral valganciclovir as preemptive therapy is effective for cytomegalovirus infection in allogeneic hematopoietic stem cell transplant recipients. Int J Hematol 89, 231–237 (2009). https://doi.org/10.1007/s12185-008-0249-2

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  • DOI: https://doi.org/10.1007/s12185-008-0249-2

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