Ganciclovir-related neutropenia after preemptive therapy for cytomegalovirus infection: comparison between cord blood and bone marrow transplantation

Annals of Hematology
Akira TomonariShigetaka Asano

Abstract

We studied ganciclovir (GCV)-related neutropenia after preemptive therapy for cytomegalovirus infection: 9 of 17 (53%) cord blood transplantation (CBT) patients and 18 of 20 (90%) bone marrow transplantation (BMT) patients developed GCV-related neutropenia with an absolute neutrophil count (ANC) of less than 1,000/microl. Among the patients who did not receive granulocyte colony-stimulating factor, 2 (13%) and 1 (7%) CBT patients, and 10 (56%) and 8 (44%) BMT patients, developed neutropenia with an ANC of less than 500 and 250/microl, respectively. The incidences of neutropenia in patients with an ANC of less than 1,000, 500, and 250/microl were significantly lower after CBT in comparison with BMT. Two BMT patients, but no CBT patients, developed neutropenic fever, and both patients recovered after antibiotic therapy. In CBT patients, a creatinine clearance rate of less than 50 ml/min and an absence of steroid therapy were associated with a greater incidence of GCV-related neutropenia. No risk factors for GCV-related neutropenia were found in BMT patients. These results suggest that GCV may be less toxic to myeloid progenitor cells from cord blood than those from bone marrow.

Citations

Mar 10, 2015·Biological & Pharmaceutical Bulletin·Kazuaki MatsumotoYasuo Takeda
Aug 2, 2011·Asian Pacific Journal of Tropical Medicine·Suchun YanWei Guo
Apr 24, 2013·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·G VentonJ El-Cheikh
Jul 31, 2009·Antiviral Chemistry & Chemotherapy·Audrey Janoly-DumenilMarie-Thérèse Zabot
Aug 5, 2010·Transplantation·Robin K AveryBelinda Yen-Lieberman

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