Ganciclovir treatment of cytomegalovirus disease in immunocompromised children.
Twelve immunocompromised children were treated with 13 courses of intravenously administered ganciclovir for severe cytomegalovirus disease. All children were allograft recipients; 6 received organ transplants (5 liver, 1 kidney) and 6 received bone marrow. They presented with one or more of the following forms of cytomegalovirus disease: pneumonitis, 9; hepatitis, 3; colitis, 2; peritonitis, 1; and retinitis, 1. Clinical improvement was observed in 7 (58%) of 12 patients during ganciclovir therapy. Cessation of active viral replication during therapy accompanied 69% of the treatment courses. Mild and transient increases in creatinine and liver function tests and/or decreases in neutrophil count accompanied 77% of treatment courses but neutropenia (less than 1000 cells/mm3) did not occur. Transient decreases in platelet counts accompanied therapy in 3 bone marrow allograft recipients, but greater than 50% decrease in lymphocyte count was not seen. We conclude that ganciclovir is safe and appears to have a beneficial effect on cytomegalovirus disease in some pediatric transplant recipients.
Gudnason
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T
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis 55455.
Belani
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Balfour
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D000212:Acyclovir / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000293:Adolescent; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D005260:Female; D015774:Ganciclovir; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007223:Infant; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D012189:Retrospective Studies
D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D015774:Ganciclovir; D000212:Acyclovir