Abstract |
Alemtuzumab (Campath-1H)-based conditioning regimens are effective in preventing GVHD, but are associated with very high rates of cytomegalovirus (CMV) infection, a major limitation to their use. We evaluated 85 patients receiving conditioning with fludarabine 30 mg/m2/day (day -7 to day -3), alemtuzumab 20 mg/day (day -7 to day -3), and melphalan 140 mg/m2 on day -2. The initial patients received post transplant CMV prophylaxis with high-dose acyclovir. A very high incidence of CMV viremia was observed as has been commonly reported after alemtuzumab-based conditioning. Sixty-seven subsequent patients received pre-transplant ganciclovir and high-dose valacyclovir after engraftment. The cumulative incidence of CMV infection in the valacyclovir cohort was 29%. This compared favorably to the cumulative incidence of 53% in patients receiving only acyclovir (P = 0.004) and to literature data. CMV prophylaxis with pre-transplant ganciclovir and high-dose valacyclovir after engraftment appears effective in preventing the excessive incidence of CMV infection after alemtuzumab-based conditioning regimens.
|
Authors | J Kline, D A Pollyea, W Stock, A Artz, E Rich, L Godley, T Zimmerman, K Thompson, K Pursell, R A Larson, K van Besien |
Journal | Bone marrow transplantation
(Bone Marrow Transplant)
Vol. 37
Issue 3
Pg. 307-10
(Feb 2006)
ISSN: 0268-3369 [Print] England |
PMID | 16400339
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, N.I.H., Extramural)
|
Chemical References |
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Humanized
- Antibodies, Neoplasm
- Antineoplastic Agents
- Antiviral Agents
- Alemtuzumab
- Valine
- Valacyclovir
- Ganciclovir
- Acyclovir
|
Topics |
- Acyclovir
(administration & dosage, analogs & derivatives)
- Adolescent
- Adult
- Aged
- Alemtuzumab
- Antibodies, Monoclonal
(administration & dosage)
- Antibodies, Monoclonal, Humanized
- Antibodies, Neoplasm
(administration & dosage)
- Antineoplastic Agents
(administration & dosage)
- Antiviral Agents
(administration & dosage)
- Bone Marrow Transplantation
(adverse effects)
- Cytomegalovirus Infections
(etiology, prevention & control)
- Female
- Ganciclovir
(administration & dosage)
- Hematologic Neoplasms
(complications, therapy)
- Humans
- Incidence
- Male
- Middle Aged
- Transplantation Conditioning
- Transplantation, Homologous
- Valacyclovir
- Valine
(administration & dosage, analogs & derivatives)
|