Evaluation of cytomegalovirus reactivation and tolerability in seropositive umbilical cord transplant patients after implementation of an intensive prevention strategy
| Autor: | Joseph McGuirk, Erica Hochard, Leyla Shune, Omar S. Aljitawi, Sunil Abhyankar, Tara L. Lin, Michelle Rockey, Siddhartha Ganguly, Anurag Singh, Matthew Rinehart |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Ganciclovir
Adult Male medicine.medical_specialty Umbilical cord blood transplant Congenital cytomegalovirus infection Cytomegalovirus 030204 cardiovascular system & hematology Umbilical cord lcsh:RC254-282 CMV viremia 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Adverse effect Survival analysis Demography CMV reactivation business.industry lcsh:RC633-647.5 Incidence (epidemiology) virus diseases Valganciclovir Hematology General Medicine lcsh:Diseases of the blood and blood-forming organs Middle Aged medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Survival Analysis Intensive prevention medicine.anatomical_structure Oncology Tolerability CMV disease Immunology Cytomegalovirus Infections Female Virus Activation Cord Blood Stem Cell Transplantation business 030215 immunology medicine.drug |
| Zdroj: | Hematology/Oncology and Stem Cell Therapy, Vol 9, Iss 3, Pp 105-111 (2016) |
| ISSN: | 1658-3876 |
| Popis: | Objective/Background: Cytomegalovirus (CMV) causes significant morbidity and mortality in CMV seropositive patients undergoing umbilical cord blood transplants (UCBT). Our study aimed to describe the incidence of CMV reactivation and burden of disease, as well as the tolerability of an intensive prevention strategy as compared to historical prevention. Methods: This was a retrospective chart review of 33 CMV seropositive patients that underwent UCBT. The intensive prevention strategy in UCBT consisted of ganciclovir 5 mg/kg/d intravenously or valganciclovir 900 mg by mouth daily initiated at the beginning of the conditioning regimen until Day −2. Then from Day −1 to Day +100, patients received valacyclovir 2 g by mouth three times daily, and from Day +101 to Day +365, acyclovir 800 mg by mouth twice daily. Historical standard prevention was acyclovir 800 mg by mouth twice daily initiated at the beginning of the conditioning regimen until Day +365. Results: Thirty-three patients were included from 2008 to 2014. There were no differences in the adverse effects experienced between the two regimens (p = .4). CMV reactivation occurred significantly later with intensive prevention (p = .003). The median CMV viral titer at reactivation was lower in the intensive versus the historic prevention (1,800 copies/mL and 2,700 copies/mL, respectively), but was not significantly different. CMV disease occurred significantly less often in the intensive group (p = .039). Conclusion: The results from this study indicate that the intensive prevention strategy was well tolerated, significantly delayed CMV reactivation, and patients had less CMV disease. Keywords: CMV disease, CMV reactivation, CMV viremia, Cytomegalovirus, Intensive prevention, Umbilical cord blood transplant |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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