Ganciclovir therapy for cytomegalovirus disease associated with renal transplants.
Seventeen recipients of renal transplants were treated with ganciclovir for life- or sight-threatening cytomegalovirus (CMV) infection. Twelve patients had pneumonia (one with concomitant retinitis), three patients had retinitis, and two patients had generalized disease. Four (36%) of 11 patients with pneumonia due to CMV were cured, including three (30%) of 10 ventilator-dependent patients. The clinical condition of all four patients with retinitis improved when ganciclovir was administered, although three patients relapsed after discontinuation of therapy. Two of these three responded to a repeat course of therapy. Two patients with generalized disease died. A virologic response, with clearing of CMV, was noted in eight of the 17 patients (including seven of 10 patients with a favorable clinical response). Adverse effects of therapy were common and included leukopenia (six patients), thrombocytopenia (four patients), and CNS disturbances (four patients). Ganciclovir holds promise as therapy for life-threatening CMV infection in patients with renal transplants, including those patients with CMV pneumonia who are ventilator-dependent.
Snydman
D R
DR
Department of Medicine, New England Medical Center Hospitals, Tufts University School of Medicine, Boston, Massachusetts.
D000212:Acyclovir / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000188:drug therapy*; D005260:Female; D015774:Ganciclovir; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D011024:Pneumonia, Viral / Q000188:drug therapy; D011183:Postoperative Complications / Q000188:drug therapy; D012173:Retinitis / Q000188:drug therapy; D013921:Thrombocytopenia / Q000139:chemically induced
D000998:Antiviral Agents; D015774:Ganciclovir; D000212:Acyclovir