title: Phase I-II trial of foscarnet for prevention of cytomegalovirus infection in autologous and allogeneic marrow transplant recipients.
abstract: The safety and efficacy of foscarnet for prevention of cytomegalovirus (CMV) infection was evaluated in 19 CMV-seropositive bone marrow transplant (BMT) recipients. All patients received intermittent intravenous (iv) foscarnet: 40 mg/kg every 8 h from 7 days before to day 30 after BMT, then 60 mg/kg once a day until day 75. The main toxicity was transient renal dysfunction, with a greater than 50 mumol/L increase in serum creatinine above baseline in 5 of the 7 autograft recipients and in 6 of the 12 allograft recipients. Only 4 allograft recipients developed CMV infection during foscarnet prophylaxis, and no patient showed evidence of CMV disease. Because 3 allograft recipients receiving concomitant iv amphotericin B showed rapid impairment of renal function, foscarnet prophylaxis should not be given to allograft recipients requiring amphotericin B; otherwise, foscarnet prophylaxis at this dose appears safe after BMT.
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: P
authors.initials: P
authors.lastname: Reusser
authors.forename: J G
authors.initials: JG
authors.lastname: Gambertoglio
authors.forename: K
authors.initials: K
authors.lastname: Lilleby
authors.forename: J D
authors.initials: JD
authors.lastname: Meyers
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D003586:Cytomegalovirus Infections / Q000517:prevention & control*; D004341:Drug Evaluation; D005260:Female; D017245:Foscarnet; D006801:Humans; D007668:Kidney / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010746:Phosphonoacetic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D011446:Prospective Studies; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: D000998:Antiviral Agents; D017245:Foscarnet; D010746:Phosphonoacetic Acid