title: Cytomegalovirus disease in adult marrow transplant recipients receiving ganciclovir prophylaxis: a retrospective study.
abstract: In a retrospective study, we compared the incidence and risk of mortality associated with CMV disease in adult allogeneic BMT and PBSC recipients who received ganciclovir prophylaxis three-times-per-week (78 patients) vs five-times-per-week (137 patients). Active CMV infection occurred in 28 (41%) and 26 (21%) in the three- vs five-times-per-week groups, respectively (P < 0.005). CMV disease developed in 11 (16%) and five (4%) patients who received ganciclovir prophylaxis in the three-times-per-week vs five-times-per-week groups (P < 0.004). The CMV-attributable mortality rate was 1.5% and 12% in the five- vsthree-times-per-week groups, respectively (P < 0.003). Risk factors for CMV disease, significant at the P < 0.05 level in the multivariate analysis, were ganciclovir prophylaxis at three-times-per-week, receiving a T cell-depleted (TCD) marrow, and tacrolimus as prophylaxis for GVHD. These data suggest that ganciclovir five-times-per-week significantly reduced the incidence and mortality of CMV disease in allogeneic BMT and PBSC recipients. However, ganciclovir five-times-per-week was less effective for the prevention of CMV disease in patients receiving TCD marrow or tacrolimus.
authors.affiliation: Section of Infectious Diseases, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: H
authors.initials: H
authors.lastname: Maltezou
authors.forename: E
authors.initials: E
authors.lastname: Whimbey
authors.forename: D
authors.initials: D
authors.lastname: Abi-Said
authors.forename: D
authors.initials: D
authors.lastname: Przepiorka
authors.forename: R
authors.initials: R
authors.lastname: Champlin
authors.forename: J
authors.initials: J
authors.lastname: Goodrich
authors.forename: H
authors.initials: H
authors.lastname: Maltazou
authors.forename: R
authors.initials: R
authors.lastname: Champlain
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000401:mortality; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008212:Lymphocyte Depletion; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir