title: Failure of high-dose acyclovir to prevent cytomegalovirus disease after autologous marrow transplantation.
abstract: In a retrospective study, the strategy of giving high-dose acyclovir (500 mg/m2 every 8 h intravenously) from day 5 before transplantation to day 30 after transplantation was evaluated in 266 cytomegalovirus (CMV)-seropositive autograft recipients. the incidence of CMV pneumonia was compared with that in 85 control patients who did not receive high-dose acyclovir. There was no significant difference in the incidence of CMV pneumonia between groups at day 100 (Kaplan-Meier estimates, 6.3% [acyclovir] vs. 7.7% [controls], P = .63) and day 200 after transplantation (7.6% vs. 13.1%, P = .32). The overall rate of patients who presented with CMV disease without preceding excretion from blood, urine, or throat was 77%. CMV pneumonia was fatal in 9 (56%) of 16 acyclovir recipients compared with 5 (63%) of 8 controls (P = 1.0). Survival after transplantation was not different between groups (P = .68). Thus, high-dose acyclovir does not appear to be effective for prevention of CMV disease after autologous transplantation.
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington 98104, USA.
authors.forename: M
authors.initials: M
authors.lastname: Boeckh
authors.forename: T A
authors.initials: TA
authors.lastname: Gooley
authors.forename: P
authors.initials: P
authors.lastname: Reusser
authors.forename: C D
authors.initials: CD
authors.lastname: Buckner
authors.forename: R A
authors.initials: RA
authors.lastname: Bowden
mesh_terms: D000212:Acyclovir / Q000494:pharmacology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000494:pharmacology*; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir