Randomized comparison of oral valacyclovir and intravenous ganciclovir for prevention of cytomegalovirus disease after allogeneic bone marrow transplantation

Drew J. Winston, Andrew M. Yeager, Pranatharthi H. Chandrasekar, David R. Snydman, Finn Bo Petersen, Mary C. Territo, Kathy Bartoni, Ken Miller, David Schenkein, Patrick Stiff, Reid Mattison, Mary Laughlin, Witold Rybka, Margarida De Magalhaes-Silverman, John R. Wingard, Toni Mazzuli, Clare Brennan, Sharon McDermott, Mauricio Vargas, Ira C. Lee

Research output: Contribution to journalArticle

81 Scopus citations

Abstract

In this multicenter, randomized study, cytomegalovirus (CMV)-seropositive patients who received an allogeneic bone marrow transplant were provided high-dose intravenous acyclovir (500 mg/m2 q8h) from the day of transplantation until engraftment. The patients were then randomly assigned to receive either oral valacyclovir, 2 g q.i.d. (n = 83), or intravenous ganciclovir, 5 mg/kg q12h for 1 week, then 6 mg/kg once daily for 5 days per week (n = 85), until day 100 after transplantation. CMV infection occurred in 12% of the patients who received valacyclovir and in 19% of the patients who received ganciclovir (hazard ratio [HR], 1.042; 95% confidence interval [CI], 0.391-2.778; P = .934). CMV disease developed in only 2 patients who received valacyclovir and in 1 patient who received ganciclovir (HR, 1.943; 95% CI, 0.176-21.44; P = .588). Oral valacyclovir can be an effective alternative to intravenous ganciclovir for prophylaxis of CMV disease after bone marrow transplantation.

Original languageEnglish (US)
Pages (from-to)749-758
Number of pages10
JournalClinical Infectious Diseases
Volume36
Issue number6
DOIs
StatePublished - Mar 15 2003

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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    Winston, D. J., Yeager, A. M., Chandrasekar, P. H., Snydman, D. R., Bo Petersen, F., Territo, M. C., Bartoni, K., Miller, K., Schenkein, D., Stiff, P., Mattison, R., Laughlin, M., Rybka, W., De Magalhaes-Silverman, M., Wingard, J. R., Mazzuli, T., Brennan, C., McDermott, S., Vargas, M., & Lee, I. C. (2003). Randomized comparison of oral valacyclovir and intravenous ganciclovir for prevention of cytomegalovirus disease after allogeneic bone marrow transplantation. Clinical Infectious Diseases, 36(6), 749-758. https://doi.org/10.1086/367836