title: Low systemic ganciclovir exposure and preemptive treatment failure of cytomegalovirus reactivation in a transplanted child.
abstract: Prevention of cytomegalovirus (CMV) disease with ganciclovir has led to decrease morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients. In the present report, we describe a case of ganciclovir treatment failure in a HSCT child who presented a refractory CMV infection despite harbouring a susceptible strain. The failure was partly attributed to sub-therapeutic plasma ganciclovir levels. Our experience emphasizes the importance of drug monitoring in immunocompromised patients.
authors.affiliation: Division of Infectious Disease, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal.
authors.forename: Julie
authors.initials: J
authors.lastname: Autmizguine
authors.forename: Yves
authors.initials: Y
authors.lastname: Théôret
authors.forename: Elise
authors.initials: E
authors.lastname: Launay
authors.forename: Michel
authors.initials: M
authors.lastname: Duval
authors.forename: Céline
authors.initials: C
authors.lastname: Rousseau
authors.forename: Bruce
authors.initials: B
authors.lastname: Tapiéro
authors.forename: Guy
authors.initials: G
authors.lastname: Boivin
authors.forename: Philippe
authors.initials: P
authors.lastname: Ovetchkine
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000517:prevention & control*; D016903:Drug Monitoring / Q000379:methods; D024882:Drug Resistance, Viral; D015774:Ganciclovir / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D017211:Treatment Failure; D014775:Virus Activation
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir