[Foscarnet therapy for ganciclovir-refractory cytomegalovirus hepatitis in a patient who underwent bone marrow transplantation from an unrelated donor].
Cytomegalovirus (CMV) hepatitis refractory to ganciclovir treatment occurred after prolonged administration of ganciclovir in a 36-year-old woman with chronic myelogeneous leukemia who had undergone allogeneic bone marrow transplantation (BMT) from an HLA-identical unrelated donor. The number of CMV antigen-positive leukocytes in blood were well correlated with the serum levels of transaminases and the antigenemia assay was useful in monitoring CMV hepatitis. The patient was treated with foscarnet, a potent inhibitor of CMV DNA-polymerase, which led to rapid improvement of the CMV antigenemia and the transaminase concentrations. Foscarnet therapy should be considered for ganciclovir-resistant CMV disease in the setting of BMT.
Fujisaki
T
T
First Department of Internal Medicine, Kyushu University.
Gondo
H
H
Uchida
N
N
Matsuo
I
I
Takenaka
K
K
Tanimoto
K
K
Otsuka
T
T
Minematsu
T
T
Minamishima
Y
Y
Niho
Y
Y
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D003586:Cytomegalovirus Infections / Q000188:drug therapy*; D004351:Drug Resistance; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use*; D015774:Ganciclovir / Q000494:pharmacology*; D006525:Hepatitis, Viral, Human / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy
D000998:Antiviral Agents; D017245:Foscarnet; D015774:Ganciclovir