Treatment of renal allograft polyoma BK virus infection with leflunomide.

Transplantation
Michelle A JosephsonJames Williams

Abstract

Polyoma BK virus produces an aggressively destructive nephropathy in approximately 3% to 8% of renal allografts, is associated with graft loss within one year in 35% to 67% of those infected and there is no therapy of proven efficacy. Leflunomide is an immune suppressive drug with anti viral activity in vitro and in animals. We treated twenty-six patients with biopsy proven NK virus nephropathy (BKN) with either leflunomide alone (n=17) or leflunomide plus a course of cidofovir (n=9) and followed them for six to forty months. Leflunomide was dosed to a targeted blood level of active metabolite, A77 1726, of 50 microg/ml to 100 microg/ml (150 microM to 300 microM). Response to treatment was gauged by serial determinations of viral load in blood and urine (PCR), serum creatinine, and repeat allograft biopsy. In the 22 patients consistently sustaining the targeted blood levels of active drug, blood and urine viral load levels uniformly decreased over time (P<.001). Mean serum creatinine levels stabilized over the first six months of treatment, and with 12 months or more of follow-up in 16 patients the mean serum creatinine has not changed significantly from base line. Four patients who did not consistently have blood levels of act...Continue Reading

References

Apr 1, 1978·Journal of Clinical Pathology·D V ColemanW J Russell
Jul 1, 1988·The Journal of Infectious Diseases·C A AndrewsR H Rubin
Mar 1, 1980·Annals of Internal Medicine·T F HoganD L Walker
Nov 27, 1995·Transplantation·F XiaoL McChesney
Jan 28, 1999·Transplantation·P S RandhawaA J Demetris
May 8, 1999·Journal of the American Society of Nephrology : JASN·V NickeleitM J Mihatsch
Jul 6, 2000·Immunopharmacology·A C Allison
Oct 31, 2001·Clinical Transplantation·Y M BarriS R Abul-Ezz
Dec 1, 2001·Transplantation·E MylonakisJ A Fishman
Mar 9, 2002·Transplantation·James W WilliamsStephen Jensik
Jul 26, 2002·Journal of the American Society of Nephrology : JASN·Emilio RamosMatthew R Weir
Aug 16, 2002·The New England Journal of Medicine·Hans H HirschJürg Steiger
Oct 24, 2002·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Karen L HardingerDaniel C Brennan
Oct 29, 2002·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Ola BjorangPer A Andresen
Mar 5, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Pradeep V KadambiAjit P Limaye
Jun 26, 2003·Journal of Gastroenterology·Kazuaki InoueMakoto Yoshiba
Dec 16, 2003·Biochemical and Biophysical Research Communications·Mina NakagawaMamoru Watanabe

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Citations

Oct 7, 2010·International Journal of Hematology·Kazunari AokiTakayuki Ishikawa
Nov 25, 2006·Nature Clinical Practice. Nephrology·Millie SamaniegoArjang Djamali
Mar 13, 2008·Nature Clinical Practice. Nephrology·Shweta BansalAlexander Wiseman
Apr 18, 2012·Nature Reviews. Nephrology·Dirk R J Kuypers
Oct 24, 2007·Bone Marrow Transplantation·L K Dropulic, R J Jones
Apr 20, 2011·Proceedings of the National Academy of Sciences of the United States of America·Aurelio BonaviaSimon M Bushell
May 24, 2008·Transplantation·Catherine BonvoisinJean-Marie Krzesinski
Sep 25, 2008·Transplantation·Liise K KaylerParmjeet S Randhawa
Mar 20, 2009·Transplantation·Emilio RamosHans H Hirsch
Dec 4, 2009·Journal of Virology·Eva BernhoffChristine H Rinaldo
Dec 4, 2009·Journal of Virology·Joslynn A JordanWalter J Atwood
Jan 23, 2009·Journal of the American Society of Nephrology : JASN·Harsharan K SinghVolker Nickeleit
Mar 20, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Aaron Dall, Sundaram Hariharan
Mar 29, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Nicolae LecaConnie L Davis
Sep 30, 2010·Immunotherapy·Sven Teschner, Volker Burst
Feb 18, 2014·Transplantation·Rumina A ZamanEileen W Tsai
Jun 20, 2014·Current Infectious Disease Reports·Jennifer delaCruz, Kenneth Pursell
Oct 15, 2013·The Journal of Infection·Michelle Pinto, Simon Dobson
Jun 11, 2009·Current Opinion in Organ Transplantation·Nicolae Leca
Jul 29, 2008·The Journal of Antimicrobial Chemotherapy·Rachel Hilton, C Y William Tong
Feb 3, 2007·Expert Review of Anti-infective Therapy·Christine Hanssen Rinaldo, Hans H Hirsch
May 21, 2011·Expert Review of Clinical Immunology·W James Chon, Michelle A Josephson
Sep 10, 2008·Expert Opinion on Pharmacotherapy·Hsin-Yun Sun, Nina Singh
Feb 2, 2016·Néphrologie & thérapeutique·Antoine LanotBruno Hurault de Ligny
Jul 25, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Andrew S WeissAlexander C Wiseman
Jan 12, 2010·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Raghavender Boothpur, Daniel C Brennan
Sep 22, 2009·Transplantation Proceedings·M A HalimM R N Nampoory
Nov 18, 2008·Seminars in Nephrology·Meryl WaldmanJeffrey B Kopp
Apr 28, 2009·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Alexander C Wiseman
Oct 16, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Philip AcottJohn F S Crocker

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