Ganciclovir Therapy for Cytomegalovirus Infections in Recipients of Bone Marrow Transplants and Other Immunosuppressed Patients

Longitudinal fluctuations in cytomegalovirus load in bone marrow transplant patients: relationship between peak virus load, donor/recipient serostatus, acute GVHD and CMV disease

“…Prophylaxis and pre-emptive therapy are now used widely in the management of the bone marrow transplant recipient. [12][13][14][15][16][17] In our study all allograft recipients received acyclovir prophylaxis, but the patients were not routinely given pre-emptive ganciclovir therapy. The observation that viral load was significantly higher in patients treated with GCV can be explained by the fact that the majority of patients were given GCV therapy based on clinical assessment of symptoms.…”

“…12,13 In addition, placebo-controlled trials of ganciclovir (GCV) and acyclovir (ACV), have demonstrated that these drugs can decrease HCMV infection and, in some cases, disease when used prophylactically. [14][15][16][17] Nevertheless, HCMV continues to cause significant disease in bone marrow recipients, necessitating continued routine surveillance for HCMV coupled with specific diagnostic testing in target organs such as lung, liver and gut. Despite the significant reduction in HCMV disease during the first 100 days post-transplant offered by prophylactic GCV strategies there is an increasing appreciation that late presentation of HCMV disease can occur (Ͼ100 days post-transplant) which has a high mortality.…”

New Strategies for Prevention and Therapy of Cytomegalovirus Infection and Disease in Solid-Organ Transplant Recipients

“…Intravenous ganciclovir has been successfully used in uncontrolled, nonrandomized therapeutic trials to treat solid-organ transplant recipients with CMV disease (52,59,77,83,88,90,106,116,185,186,192,207,212,217,226,254,275,281,296,322,324,325,339,386,397,428,430,446,451,490,496). To date, intravenous ganciclovir remains the drug of choice for the treatment of CMV disease.…”

Inhibitory effects of potent inhibitors of human immunodeficiency virus and cytomegalovirus on the growth of human granulocyte-macrophage progenitor cells in vitro

“…These compounds are also myelotoxic in patients. When given to patients with the acquired immunodeficiency syndrome (AIDS) and CMV-induced pneumonia or retinitis, zidovudine and ganciclovir frequently cause neutropenia, anemia and thrombocytopenia (6,7). Supportive care based on erythrocyte or platelet transfusion may overcome anemia or thrombocytopenia, but when acute neutropenia develops, antiviral treatment has to be interrupted until granulocyte counts are normalized.…”