Ganciclovir for the treatment of disseminated CMV disease without pneumonia in allogeneic t-lymphocyte depleted bone marrow transplantation

D. Engelhard*, E. Naparstek, R. Or, A. Nagler, J. Jacobs, M. Ben Shahar, I. Hardan, H. Baciu, D. Raveh, S. Slavin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Treatment with ganciclovir was assessed in 13 patients who underwent allogeneic T-lymphocyte depleted bone marrow transplantation (BMT) for a variety of malignant hematological disorders and subsequently developed severe cytomegalovirus (CMV) disease without pneumonia. The manifestations of CMV disease appeared on days 23-105 (median 51) post BMT, and included gastrointestinal symptoms, weight loss, fever, disturbed liver function, leukopenia and thrombocytopenia. Ganciclovir was administered for 14 days, without the addition of intravenous immunoglobulins. Following therapy, the clinical manifestations subsided in most of the patients, while leukopenia, thrombocytopenia and liver dysfunction resolved in about half of the patients. One patient who experienced recurrent CMV disease responded to a second course of ganciclovir. Poor response to ganciclovir treatment was observed in 2 of the 3 patients with grade 4 graft-versus-host disease (GVHD). Our experience suggests that a 2-week course of ganciclovir may be effective in BMT recipients who develop severe CMV-associated disease without lung involvement, especially when there is no concommitant severe GVHD.

Original languageEnglish
Pages (from-to)143-146
Number of pages4
JournalLeukemia and Lymphoma
Volume10
Issue number1-2
DOIs
StatePublished - 1993
Externally publishedYes

Keywords

  • Cytomegalovirus disease
  • Ganciclovir
  • T-lymphocyte depleted bone marrow transplantation graft-versus-host disease

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