Cidofovir for cytomegalovirus reactivation in pediatric patients after hematopoietic stem cell transplantation

A prospective study of BK-virus-associated haemorrhagic cystitis in paediatric patients undergoing allogeneic haematopoietic stem cell transplantation

“…Other authors have shown that this drug can be used safely with some precautions in kidney transplant and HSCT patients. 21,[39][40][41][42] In conclusion, we found a significant correlation in paediatric patients between BK virus replication in both urine and plasma with post-HSCT HC; moreover, a threshold with high specificity and PPV for HC was found by BK load determination. These data deserve further prospective investigation given the small sample size of our study and in view of the possible use of the BK load as a guide for a pre-emptive treatment strategy for HC.…”

Diagnostic Utility of Human Cytomegalovirus-Specific T-Cell Response Monitoring in Predicting Viremia in Pediatric Allogeneic Stem-Cell Transplant Patients

“…The induction treatment was continued with maintenance of foscarnet at 1ϫ90 mg/kg/day or ganciclovir at 1ϫ5 mg/kg/day for 3 to 5 days/week for 2 weeks. Patients with recurrent CMV reactivation were retreated with foscarnet or, at physician discretion, switched to ganciclovir or cidofovir (53). CMV immunoglobulins were administered to patients with CMV disease or, in some cases, in patients with frequent (Ն3 episodes) CMV reactivation.…”

CMV infections after hematopoietic stem cell transplantation

“…13 Resistance to antiviral therapy is quite rare in SCT patients and increasing antigenemia or CMV DNA early after initiation of antiviral therapy is usually not a sign of antiviral resistance and does not necessitate change of therapy. 14,15 Cidofovir is an alternative as a second-line agent 16,17 and, recently, case reports have been published of treatment with leflunomide or artesunate in patients failing other antiviral therapy. [18][19][20] The prognosis in patients with established CMV disease is still poor.…”