title: Cytomegalovirus retinitis complicating combination therapy with rituximab and fludarabine.
abstract: Cytomegalovirus (CMV) retinitis is exceptionally rare outside the clinical context of acquired immunodeficiency syndrome and organ allografting. In a population where seropositivity for past CMV infection exceeded 90 %, CMV retinitis was observed in five of 138 patients (3.6 %) receiving fludarabine-containing regimens together with rituximab, which was significantly more frequent than in 141 patients receiving fludarabine-containing regimens alone, where no case was observed (P = 0.029). Treatment of CMV retinitis comprised both intravitreal and systemic ganciclovir/foscarnet. Upon recovery, secondary retinal atrophy occurred in all patients, leading to blindness in 86 % of affected eyes. CMV retinitis is an important complication in patients receiving concomitant rituximab and fludarabine-containing regimens.
authors.affiliation: Department of Medicine, Queen Mary Hospital, Professorial Block, Pokfulam Road, Hong Kong, China.
authors.forename: Thomas S Y
authors.initials: TS
authors.lastname: Chan
authors.forename: Carol Y M
authors.initials: CY
authors.lastname: Cheung
authors.forename: Ian Y L
authors.initials: IY
authors.lastname: Yeung
authors.forename: Yu-Yan
authors.initials: YY
authors.lastname: Hwang
authors.forename: Harinder
authors.initials: H
authors.lastname: Gill
authors.forename: Ian Y
authors.initials: IY
authors.lastname: Wong
authors.forename: Yok-Lam
authors.initials: YL
authors.lastname: Kwong
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage* / Q000009:adverse effects*; D017726:Cytomegalovirus Retinitis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069283:Rituximab; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014740:Vidarabine; C024352:fludarabine