Valganciclovir for treatment of cytomegalovirus viremia in patients following allogeneic hematopoietic stem cell transplantation

Abstract

To investigate the efficacy and safety of valganciclovir in treatment of cytomegalovirus viremia in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Nineteen patients following allo-HSCT were diagnosed as with cytomegalovirus viremia with the CMV-DNA load of higher than 6.0 x 10(2) copies/ml confirmed by polymerase chain reaction (PCR) took orally valganciclovir at the dose of 900 mg bid for 14 days followed by 900 mg Qd for another 14 days. Since 4 weeks after the valganciclovir treatment PCR was conducted in the 6th, 8th, 12th, 16th, and 24th weeks later to detect the CMV-DNA level. CMV viremia was confirmed 40 days after HSCT on average with a median CMV-DNA load of 3.346 x 10(3) copies/ml. The total effective rate of valganciclovir was 94.7% (18/19). The CMV-DNA turned to negative in 7 d in 11 cases with a negative transfer rate of 54.7%, and in 14 d in 16 cases with a negative transfer rate of 84.2%. The median CMV DNA load reduction was 0.75 copies/ml and 0.084 log10 copies/ml/day. Severe adverse effects were not observed and CMV-related disease did not occur. Valganciclovir is an attractive and safe alternative for preemptive CMV viremia treatment in allo-HSCT recipients.