title: Foscarnet therapy for ganciclovir-resistant cytomegalovirus retinitis after stem cell transplantation: effective monitoring of CMV infection by quantitative analysis of CMV mRNA.
abstract: We report three pediatric patients with ganciclovir-resistant cytomegalovirus (CMV) retinitis who were successfully treated with foscarnet. The patients were recipients of hematopoietic stem cell transplantation (SCT) from HLA-mismatched donors. Because these patients had developed or experienced progressive CMV retinitis during ganciclovir therapy, they received foscarnet therapy at 60 mg/kg every 8 h. Their retinitis resolved promptly after initiating foscarnet therapy, suggesting foscarnet's effectiveness in treating ganciclovir-resistant CMV infection. The amount of CMV mRNA was quantitatively measured using an NASBA technique, which amplified the beta2.7 transcripts specific for CMV replication. This technique was useful for monitoring disease activity in a more rapid and sensitive manner than the PCR assay for CMV DNA.
authors.affiliation: Department of Developmental Medicine (Pediatrics), Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ohta
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuda
authors.forename: S
authors.initials: S
authors.lastname: Tokimasa
authors.forename: A
authors.initials: A
authors.lastname: Sawada
authors.forename: J Y
authors.initials: JY
authors.lastname: Kim
authors.forename: J
authors.initials: J
authors.lastname: Sashihara
authors.forename: K
authors.initials: K
authors.lastname: Amo
authors.forename: H
authors.initials: H
authors.lastname: Miyagawa
authors.forename: K
authors.initials: K
authors.lastname: Tanaka-Taya
authors.forename: S
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Tano
authors.forename: T
authors.initials: T
authors.lastname: Aono
authors.forename: K
authors.initials: K
authors.lastname: Yamanishi
authors.forename: S
authors.initials: S
authors.lastname: Okada
authors.forename: J
authors.initials: J
authors.lastname: Hara
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000008:administration & dosage*; D002648:Child; D003587:Cytomegalovirus / Q000235:genetics; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D024882:Drug Resistance, Viral; D005260:Female; D017245:Foscarnet / Q000008:administration & dosage*; D015774:Ganciclovir / Q000008:administration & dosage; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D021141:Nucleic Acid Amplification Techniques; D012367:RNA, Viral / Q000097:blood
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D017245:Foscarnet; D015774:Ganciclovir