PMID- 26354293
OWN - NLM
STAT- MEDLINE
DCOM- 20161102
LR  - 20181202
IS  - 1399-3062 (Electronic)
IS  - 1398-2273 (Linking)
VI  - 17
IP  - 6
DP  - 2015 Dec
TI  - Occurrence of adverse events caused by valganciclovir as pre-emptive therapy for 
      cytomegalovirus infection after allogeneic stem cell transplantation is reduced 
      by low-dose administration.
PG  - 810-5
LID - 10.1111/tid.12456 [doi]
AB  - BACKGROUND: Pre-emptive therapy with valganciclovir (VGCV) has become the 
      standard therapy for preventing cytomegalovirus (CMV) infection after allogeneic 
      hematopoietic stem cell transplantation (HSCT). The effectiveness of low-dose 
      VGCV (900 mg per day) has been shown to be equal to that of standard-dose VGCV 
      (900 mg twice daily); however, individualized optimal dosing and toxicity of VGCV 
      have not been reported. METHODS: We conducted a retrospective study to evaluate 
      the optimal dose of VGCV as pre-emptive therapy for preventing CMV infection by 
      comparing the frequency of adverse events (AEs) and clinical efficacy in a 
      low-dose VGCV group with those in a standard-dose VGCV group. Thirty-eight 
      patients who were administered VGCV because of CMV antigenemia after HSCT were 
      analyzed. RESULTS: Neutropenia (standard-dose group: 33%, low-dose group: 15%, P 
      = 0.26) and thrombocytopenia (standard-dose group: 39%, low-dose group: 15%, P = 
      0.14) were frequent AEs of VGCV, and a significantly higher frequency of overall 
      AEs was detected in the standard-dose group than in the low-dose group (P < 
      0.01). In comparison of dosage based on weight, dosage of VGCV >27 mg/kg was 
      closely related to onset of AEs (P = 0.04). CONCLUSIONS: Low-dose VGCV was not 
      inferior in clinical efficacy, including clearance rate of CMV antigenemia and 
      incidence of consequent CMV disease, to standard-dose VGCV as was previously 
      reported. Initial low-dose VGCV for pre-emptive CMV therapy markedly reduces 
      hematologic toxicity and has clinical efficacy equivalent to that of 
      standard-dose VGCV. It is therefore reasonable for patients, except for 
      noticeably overweight patients, to be given initial low-dose VGCV.
CI  - (c) 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Takahata, M
AU  - Takahata M
AD  - Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan.
FAU - Hashino, S
AU  - Hashino S
AD  - Health Care Center, Hokkaido University, Sapporo, Japan.
FAU - Nishio, M
AU  - Nishio M
AD  - Department of Hematology, NTT Higashinihon Sapporo Hospital, Sapporo, Japan.
FAU - Sugita, J
AU  - Sugita J
AD  - Department of Hematology, Hokkaido University Hospital, Sapporo, Japan.
FAU - Shigematsu, A
AU  - Shigematsu A
AD  - Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan.
FAU - Onozawa, M
AU  - Onozawa M
AD  - Department of Hematology, Hokkaido University Hospital, Sapporo, Japan.
FAU - Fujimoto, K
AU  - Fujimoto K
AD  - Department of Hematology, Hokkaido University Hospital, Sapporo, Japan.
FAU - Endo, T
AU  - Endo T
AD  - Department of Hematology, Hokkaido University Hospital, Sapporo, Japan.
FAU - Kondo, T
AU  - Kondo T
AD  - Department of Hematology, Hokkaido University Hospital, Sapporo, Japan.
FAU - Tanaka, J
AU  - Tanaka J
AD  - Department of Hematology, Tokyo Women's Medical University Hospital, Tokyo, 
      Japan.
FAU - Imamura, M
AU  - Imamura M
AD  - Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan.
FAU - Teshima, T
AU  - Teshima T
AD  - Department of Hematology, Hokkaido University Hospital, Sapporo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20151105
PL  - Denmark
TA  - Transpl Infect Dis
JT  - Transplant infectious disease : an official journal of the Transplantation 
      Society
JID - 100883688
RN  - 0 (Antiviral Agents)
RN  - GCU97FKN3R (Valganciclovir)
RN  - P9G3CKZ4P5 (Ganciclovir)
SB  - IM
MH  - Antiviral Agents/administration & dosage/*adverse effects/therapeutic use
MH  - Cytomegalovirus Infections/*drug therapy
MH  - Dose-Response Relationship, Drug
MH  - Ganciclovir/administration & dosage/adverse effects/*analogs & 
      derivatives/therapeutic use
MH  - Humans
MH  - Neutropenia/chemically induced
MH  - Stem Cell Transplantation/*adverse effects
MH  - Thrombocytopenia/chemically induced
MH  - Valganciclovir
OTO - NOTNLM
OT  - CMV
OT  - VGCV
OT  - adverse events
OT  - low-dose administration
OT  - pre-emptive therapy
EDAT- 2015/09/12 06:00
MHDA- 2016/11/03 06:00
CRDT- 2015/09/11 06:00
PHST- 2015/06/29 00:00 [received]
PHST- 2015/08/09 00:00 [revised]
PHST- 2015/08/18 00:00 [accepted]
PHST- 2015/09/11 06:00 [entrez]
PHST- 2015/09/12 06:00 [pubmed]
PHST- 2016/11/03 06:00 [medline]
AID - 10.1111/tid.12456 [doi]
PST - ppublish
SO  - Transpl Infect Dis. 2015 Dec;17(6):810-5. doi: 10.1111/tid.12456. Epub 2015 Nov 
      5.