Oral valganciclovir versus ganciclovir as delayed pre‐emptive therapy for patients after allogeneic hematopoietic stem cell transplant: a pilot trial (04‐0274) and review of the literature

Chawla, J.S.; Ghobadi, Armin; Mosley, James C.; Verkruyse, Linda; Trinkaus, Kathryn; Abboud, Camille N.; Cashen, Amanda F.; Stockerl-Goldstein, Keith; Uy, Brian; Westervelt, Peter; DiPersio, John F.; Vij, Ravi

doi:10.1111/j.1399-3062.2011.00689.x

Cited by 26 publications

(13 citation statements)

References 35 publications

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“…In terms of CMV treatment, although the rates of clearance of CMV viremia are similar with oral valganciclovir and ganciclovir in the post-allo-HSCT population [20], ganciclovir remains the drug of choice in our allo-HSCT setting. Moreover, most of the patients with CMV reactivation (81.3%) in our study cohort were treated with CMV immunoglobulin simultaneously.…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus Infection and Treatment in Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Study from a Single Institution in an Endemic Area

Lin¹,

Han²,

Hwang³

et al. 2017

Tjh

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Objective:Although Cytomegalovirus (CMV) infection is a major complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT), the risk factors for CMV reactivation and treatment failure in CMV endemic areas have remained unclear. This study investigated the risk factors for CMV reactivation among allo-HSCT recipients in an area where CMV is highly endemic.Materials and Methods:Medical records of 82 allo-HSCT recipients from a CMV endemic area were retrospectively reviewed. The patients were stratified into two groups: those with CMV reactivation (n=32) and those without CMV reactivation (n=50). We investigated possible variables associated with CMV reactivation and treatment failure.Results:Univariate analyses showed that non-remission disease status [hazard ratio (HR): 2.15; p=0.032] and ≥grade III acute graft-versus-host disease (GVHD) (HR: 3.07; p=0.002) were associated with CMV reactivation. Multivariate analysis further demonstrated that older age (HR: 1.03; p=0.029) and ≥grade III acute GVHD (HR: 2.98; p=0.012) were associated with CMV reactivation. Overall survival time seemed lower among patients with CMV reactivation than among patients without CMV reactivation, although the difference was not statistically significant (p=0.165). The absence of ≥grade III acute GVHD was associated with successful CMV treatment in the current study (odds ratio: 4.40; p=0.008).Conclusion:Prophylactic anti-CMV therapy might need to be considered for allo-HSCT recipients who have ≥grade III GVHD.

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Section: Discussionmentioning

confidence: 99%

Cytomegalovirus Infection and Treatment in Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Study from a Single Institution in an Endemic Area

Lin¹,

Han²,

Hwang³

et al. 2017

Tjh

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“…In most transplant centers, antiviral therapy with ganciclovir is the first choice of both prophylaxis of high-risk patients and management of active CMV disease [43]. However, following HSCT, non-drug-responding patients benefit from the restoration of the CMV-directed immune response by adoptive transfer of CMV-specific T cells [44].…”

Section: Common Lesson From Patients Who Underwent Allogeneic Hematopmentioning

confidence: 99%

Update on viral infections in lung transplantation

Uhlin

Mattsson²,

Maeurer³

2012

Current Opinion in Pulmonary Medicine

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“…In a pilot prospective randomized clinical trial, valganciclovir was compared to ganciclovir as preemptive therapy for CMV viremia in the post‐allogeneic HSCT population . Valganciclovir was not inferior in efficacy to ganciclovir as preemptive therapy, with rates of viral clearance at 28 days of 89.5% and 83%, respectively.…”

Section: Antiviral Prophylaxis and Therapy Strategymentioning

confidence: 99%

Advances inCMVinfection prevention and treatment after allo‐HSCT

Girmenia

2019

Adv Cell Gene Ther

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Cytomegalovirus (CMV) remains a major cause of morbidity and mortality in allogeneic hematopoietic stem cell transplant (HSCT) recipients. Despite this knowledge, a number of CMV-related diagnostic and therapeutic issues remain critical. No uniform guidance exists for the best strategy to monitor and prevent CMV infection and disease. In particular, we lack standard threshold values for assessing the CMV DNAemia in the monitoring of CMV infection; there is no consensus in the adoption of immunoglobulin therapy and adoptive transfer of HSCT donor-derived CMV-specific T cells. Furthermore, antiviral drugs used in the preemptive therapy are characterized by high levels of toxicity. Of interest, recent availability of new drugs will probably modify the antiviral strategy in a large proportion of patients. The uncertainty in the management of CMV infections is further complicated by the continuous evolution in the transplantation strategies and the consequent infectious risk. This paper will focus on challenging issues in the monitoring, prevention, and treatment of CMV infections in allo-HSCT populations. Assessment of pretransplant CMV status, immunological monitoring after transplant, and CMV disease prevention and therapy strategies will be discussed. K E Y W O R D Scytomegalovirus, diagnosis, hematopoietic stem cell transplant, prophylaxis

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Oral valganciclovir versus ganciclovir as delayed pre‐emptive therapy for patients after allogeneic hematopoietic stem cell transplant: a pilot trial (04‐0274) and review of the literature

Abstract: In this trial, the rates of clearance of viremia appear to be similar with VGV and GCV.

Cited by 26 publications

References 35 publications

Cytomegalovirus Infection and Treatment in Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Study from a Single Institution in an Endemic Area

Cytomegalovirus Infection and Treatment in Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Study from a Single Institution in an Endemic Area

Update on viral infections in lung transplantation

Advances inCMVinfection prevention and treatment after allo‐HSCT

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