Occurrence of adverse events caused by valganciclovir as pre-emptive therapy for cytomegalovirus infection after allogeneic stem cell transplantation is reduced by low-dose administration.
Transpl Infect Dis
; 17(6): 810-5, 2015 Dec.
Article
en En
| MEDLINE
| ID: mdl-26354293
ABSTRACT
BACKGROUND:
Pre-emptive therapy with valganciclovir (VGCV) has become the standard therapy for preventing cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (HSCT). The effectiveness of low-dose VGCV (900 mg per day) has been shown to be equal to that of standard-dose VGCV (900 mg twice daily); however, individualized optimal dosing and toxicity of VGCV have not been reported.METHODS:
We conducted a retrospective study to evaluate the optimal dose of VGCV as pre-emptive therapy for preventing CMV infection by comparing the frequency of adverse events (AEs) and clinical efficacy in a low-dose VGCV group with those in a standard-dose VGCV group. Thirty-eight patients who were administered VGCV because of CMV antigenemia after HSCT were analyzed.RESULTS:
Neutropenia (standard-dose group 33%, low-dose group 15%, P = 0.26) and thrombocytopenia (standard-dose group 39%, low-dose group 15%, P = 0.14) were frequent AEs of VGCV, and a significantly higher frequency of overall AEs was detected in the standard-dose group than in the low-dose group (P < 0.01). In comparison of dosage based on weight, dosage of VGCV >27 mg/kg was closely related to onset of AEs (P = 0.04).CONCLUSIONS:
Low-dose VGCV was not inferior in clinical efficacy, including clearance rate of CMV antigenemia and incidence of consequent CMV disease, to standard-dose VGCV as was previously reported. Initial low-dose VGCV for pre-emptive CMV therapy markedly reduces hematologic toxicity and has clinical efficacy equivalent to that of standard-dose VGCV. It is therefore reasonable for patients, except for noticeably overweight patients, to be given initial low-dose VGCV.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Antivirales
/
Ganciclovir
/
Infecciones por Citomegalovirus
/
Trasplante de Células Madre
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Transpl Infect Dis
Asunto de la revista:
TRANSPLANTE
Año:
2015
Tipo del documento:
Article
País de afiliación:
Japón