A Modified Intensive Strategy to Prevent Cytomegalovirus Disease in Seropositive Umbilical Cord Blood Transplantation Recipients

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Joshua Aiden HillFilippo Milano

Abstract

We previously demonstrated a lower rate of cytomegalovirus (CMV) reactivation and disease among seropositive umbilical cord blood transplantation (CBT) recipients receiving an intensive prophylaxis strategy consisting of ganciclovir on days -8 to -2 pretransplantation, high-dose valacyclovir post-transplantation, and twice-weekly serum CMV polymerase chain reaction testing. We hypothesized that a modified intensive strategy excluding pretransplantation ganciclovir would be similarly effective. We compared the risk of CMV reactivation, occurrence of CMV disease, and duration of anti-CMV therapy by day 100 post-CBT in patients receiving the modified intensive and intensive strategies. Forty patients received the modified intensive strategy, and 43 received the intensive strategy. There was no difference in the hazard for CMV reactivation (hazard ratio, 1.1; P = .77). No patients in the modified intensive cohort, but 2 patients in the intensive cohort, developed CMV disease (P = .53). There was no difference in the hazard for early (≤30 days post-CBT; P = .76) or high-level (>1000 IU/mL; P = .37) CMV reactivation. Patients in the modified intensive cohort had marginally higher CMV viral loads and percentage of days of CMV detectio...Continue Reading

References

Apr 4, 2002·Blood·Per LjungmanUNKNOWN Valacyclovir International Bone Marrow Transplant Study Group
Mar 9, 2004·Journal of Clinical Microbiology·Michael BoeckhLawrence Corey
Dec 22, 2004·Kidney International·Sangeeta R HingoraniGeorge B McDonald
Sep 30, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Jill C BeckMichael R Verneris
Jun 28, 2016·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Karen BallenMarcie L Riches
Oct 30, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Per LjungmanUNKNOWN Disease Definitions Working Group of the Cytomegalovirus Drug Development Forum
Mar 11, 2017·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Juliet N BarkerElizabeth Shpall
Oct 8, 2017·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Aimee E HammerstromStefan O Ciurea
Dec 7, 2017·The New England Journal of Medicine·Francisco M MartyCyrus Badshah

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Citations

Dec 14, 2018·Current Opinion in Infectious Diseases·Sanjeet S Dadwal
Mar 10, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Elisabetta XueJoshua A Hill
Sep 25, 2018·Expert Review of Vaccines·Don Jeffrey DiamondJohn A Zaia
May 10, 2021·Transplantation and Cellular Therapy·Amanda L OlsonUNKNOWN American Society for Transplantation and Cellular Therapy Cord Blood Special Interest Group
Jun 24, 2021·Hematology/oncology and Stem Cell Therapy·Daniel R ReedKaren K Ballen
Dec 3, 2021·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Kelly G HawksAmir A Toor

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