High dose valacyclovir for cytomegalovirus prophylaxis following allogeneic hematopoietic cell transplantation.
J Oncol Pharm Pract
; 29(1): 130-137, 2023 Jan.
Article
em En
| MEDLINE
| ID: mdl-34854771
ABSTRACT
INTRODUCTION:
Cytomegalovirus (CMV) is one of the most common and clinically significant viral infections following allogeneic hematopoietic cell transplantation (HCT). Currently available options for CMV prophylaxis and treatment present challenges related to side effects and cost.METHODS:
In this retrospective medical record review, the incidence of clinically significant CMV infection (CMV disease or reactivation requiring preemptive treatment) following allogeneic HCT was compared in patients receiving valacyclovir 1â g three times daily versus acyclovir 400â mg every 12â h for viral prophylaxis.RESULTS:
Forty-five patients who received valacyclovir were matched based on propensity scoring to 35 patients who received acyclovir. All patients received reduced-intensity conditioning regimens containing anti-thymocyte globulin. Clinically significant CMV infection by day + 180 was lower in the valacyclovir group compared to the acyclovir group (18% vs. 57%, p = 0.0004). Patients receiving valacyclovir prophylaxis also had less severe infection evidenced by a reduction in CMV disease, lower peak CMV titers, delayed CMV reactivation, and less secondary neutropenia.CONCLUSION:
Prospective evaluation of valacyclovir 1â g three times daily for viral prophylaxis following allogeneic HCT is warranted. Due to valacyclovir's favorable toxicity profile and affordable cost, it has the potential to benefit patients on a broad scale as an option for CMV prophylaxis.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por Citomegalovirus
/
Transplante de Células-Tronco Hematopoéticas
Limite:
Humans
Idioma:
En
Revista:
J Oncol Pharm Pract
Assunto da revista:
FARMACIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos