Daniel R Reed, Gina R Petroni, Melissa West, Caroline Jones, Abeer Alfaraj, Paige G Williams, Kathlene DeGregory, Kyle Grose, Sandra Monson, Indumathy Varadarajan, Leonid Volodin, Gerald R Donowitz, Tamila L Kindwall-Keller, Karen K Ballen
{"title":"移植前预防性使用更昔洛韦减少造血干细胞移植后巨细胞病毒感染。","authors":"Daniel R Reed, Gina R Petroni, Melissa West, Caroline Jones, Abeer Alfaraj, Paige G Williams, Kathlene DeGregory, Kyle Grose, Sandra Monson, Indumathy Varadarajan, Leonid Volodin, Gerald R Donowitz, Tamila L Kindwall-Keller, Karen K Ballen","doi":"10.1016/j.hemonc.2021.05.001","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective/background: </strong>Cytomegalovirus (CMV) reactivation remains a serious complication after allogeneic hematopoietic cell transplantation (HCT) occurring in approximately 60-70% of CMV-seropositive HCT recipients. CMV reactivation leads to adverse outcomes including end-organ damage, graft-versus-host disease, and graft failure.</p><p><strong>Methods: </strong>Ganciclovir was administered pretransplant at 5 mg/kg twice daily intravenously from the start of conditioning to Day T-2 to CMV-seropositive patients receiving their first allogeneic HCT. CMV DNA was monitored weekly until at least Day 100 posttransplant.</p><p><strong>Results: </strong>A total of 109 consecutive patients were treated, median age 57 (range 20-73) years. Of these, 36 (33%) patients had a CMV reactivation within the first 105 days posttransplant with a median time of reactivation of 52.5 (range 36-104) days posttransplant. The cumulative incidence of CMV reactivation at Day 105 posttransplant was 33.1% (95% confidence interval: 24.4-42.0). One patient developed CMV disease.</p><p><strong>Conclusion: </strong>The use of pretransplant ganciclovir was associated with low incidence of CMV reactivation and disease. These data suggest that pretransplant ganciclovir with preemptive therapy for viral reactivation may be a useful strategy to reduce CMV reactivation. Future prospective trials are needed to compare strategies for CMV prophylaxis.</p>","PeriodicalId":39226,"journal":{"name":"Hematology/ Oncology and Stem Cell Therapy","volume":"16 1","pages":"61-69"},"PeriodicalIF":0.0000,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hemonc.2021.05.001","citationCount":"2","resultStr":"{\"title\":\"Prophylactic Pretransplant Ganciclovir to Reduce Cytomegalovirus Infection After Hematopoietic Stem Cell Transplantation.\",\"authors\":\"Daniel R Reed, Gina R Petroni, Melissa West, Caroline Jones, Abeer Alfaraj, Paige G Williams, Kathlene DeGregory, Kyle Grose, Sandra Monson, Indumathy Varadarajan, Leonid Volodin, Gerald R Donowitz, Tamila L Kindwall-Keller, Karen K Ballen\",\"doi\":\"10.1016/j.hemonc.2021.05.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective/background: </strong>Cytomegalovirus (CMV) reactivation remains a serious complication after allogeneic hematopoietic cell transplantation (HCT) occurring in approximately 60-70% of CMV-seropositive HCT recipients. CMV reactivation leads to adverse outcomes including end-organ damage, graft-versus-host disease, and graft failure.</p><p><strong>Methods: </strong>Ganciclovir was administered pretransplant at 5 mg/kg twice daily intravenously from the start of conditioning to Day T-2 to CMV-seropositive patients receiving their first allogeneic HCT. CMV DNA was monitored weekly until at least Day 100 posttransplant.</p><p><strong>Results: </strong>A total of 109 consecutive patients were treated, median age 57 (range 20-73) years. Of these, 36 (33%) patients had a CMV reactivation within the first 105 days posttransplant with a median time of reactivation of 52.5 (range 36-104) days posttransplant. The cumulative incidence of CMV reactivation at Day 105 posttransplant was 33.1% (95% confidence interval: 24.4-42.0). One patient developed CMV disease.</p><p><strong>Conclusion: </strong>The use of pretransplant ganciclovir was associated with low incidence of CMV reactivation and disease. These data suggest that pretransplant ganciclovir with preemptive therapy for viral reactivation may be a useful strategy to reduce CMV reactivation. Future prospective trials are needed to compare strategies for CMV prophylaxis.</p>\",\"PeriodicalId\":39226,\"journal\":{\"name\":\"Hematology/ Oncology and Stem Cell Therapy\",\"volume\":\"16 1\",\"pages\":\"61-69\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-01-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.hemonc.2021.05.001\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hematology/ Oncology and Stem Cell Therapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.hemonc.2021.05.001\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hematology/ Oncology and Stem Cell Therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.hemonc.2021.05.001","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
Prophylactic Pretransplant Ganciclovir to Reduce Cytomegalovirus Infection After Hematopoietic Stem Cell Transplantation.
Objective/background: Cytomegalovirus (CMV) reactivation remains a serious complication after allogeneic hematopoietic cell transplantation (HCT) occurring in approximately 60-70% of CMV-seropositive HCT recipients. CMV reactivation leads to adverse outcomes including end-organ damage, graft-versus-host disease, and graft failure.
Methods: Ganciclovir was administered pretransplant at 5 mg/kg twice daily intravenously from the start of conditioning to Day T-2 to CMV-seropositive patients receiving their first allogeneic HCT. CMV DNA was monitored weekly until at least Day 100 posttransplant.
Results: A total of 109 consecutive patients were treated, median age 57 (range 20-73) years. Of these, 36 (33%) patients had a CMV reactivation within the first 105 days posttransplant with a median time of reactivation of 52.5 (range 36-104) days posttransplant. The cumulative incidence of CMV reactivation at Day 105 posttransplant was 33.1% (95% confidence interval: 24.4-42.0). One patient developed CMV disease.
Conclusion: The use of pretransplant ganciclovir was associated with low incidence of CMV reactivation and disease. These data suggest that pretransplant ganciclovir with preemptive therapy for viral reactivation may be a useful strategy to reduce CMV reactivation. Future prospective trials are needed to compare strategies for CMV prophylaxis.
期刊介绍：
Hematology Oncology and Stem Cell Therapy is an international, peer-reviewed, open access journal that provides a vehicle for publications of high-quality clinical as well as basic science research reports in hematology and oncology. The contents of the journal also emphasize the growing importance of hematopoietic stem cell therapy for treatment of various benign and malignant hematologic disorders and certain solid tumors.The journal prioritizes publication of original research articles but also would give consideration for brief reports, review articles, special communications, and unique case reports. It also offers a special section for clinically relevant images that provide an important educational value.
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