Half‐dose ganciclovir preemptive treatment of cytomegalovirus infection after pediatric allogeneic hematopoietic stem cell transplantation

Ju, Hee Young; Kang, Hyoung Jin; Hong, Che Ry; Lee, Jae Whan; Kim, H.; Park, K.D.; Shin, Hee Young; Park, J.D.; Choi, Eun Hwa; Lee, H.J.; Ahn, Hyo Seop

doi:10.1111/tid.12539

Cited by 14 publications

(8 citation statements)

References 25 publications

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“…No CMV disease or EBVrelated post transplantation lymphoproliferative disorder developed in this study may also due to preemptively treating for viremia. 44,45 Similar to ISD-HSCT, the NRM in our haplo-cord-HSCT was lowered than others after UCBT or HID-HSCT alone. 31,46 The haplograft would achieve reliable early engraftment, which may contribute to the low incidence of post transplant neutropeniarelated infections and the low rate of NRM.…”

Section: Discussionmentioning

confidence: 57%

Myeloablative conditioning regimens with combined of haploidentical and cord blood transplantation for myelodysplastic syndrome patients

et al. 2017

Bone Marrow Transplant

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The purpose of this study was to evaluate the strategy of haploidentical (HID) stem cell combined with a small doses of umbilical cord blood (UCB) from a third-party donor transplantation (haplo-cord transplant) for treatment of myelodysplastic syndromes (MDS), by comparing with identical-sibling donor (ISD) transplantation. Eighty-five patients were included between January 2012 and December 2015, with a median 40 years old. Forty-eight patients received haplo-cord transplant and 37 patients received ISD transplant. Haplograft engraftment succeeded in all haplo-cord patients. For haplo-cord and ISD transplantation, adjusted cumulative incidences of grades 2-4 acute GvHD at 100 days were 27 and 11% (P=0.059); adjusted cumulative incidences of chronic GvHD at 2 years were 22 and 34% (P=0.215). The 2-year adjusted probabilities of overall survival were 64 and 70% (P=0.518), and of relapse-free survival were 56 and 66% (P=0.306). The 2-year adjusted cumulative incidences of relapse were 12 and 14% (P=0.743), and of non-relapse mortality were 33 and 23% (P=0.291). In conclusion, haplo-cord-HSCT achieves outcomes similar to those of ISD-HSCT for MDS and the haplo-cord-HSCT may potentially improve the outcome of HID- and UCB-HSCT alone. Thus, the haplo-cord transplantation may be a better valid alternative for MDS when an ISD is not available.

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Section: Discussionmentioning

confidence: 57%

Myeloablative conditioning regimens with combined of haploidentical and cord blood transplantation for myelodysplastic syndrome patients

et al. 2017

Bone Marrow Transplant

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“…Cytomegalovirus (CMV) antigenemia occurred in 76.5% of the patients, and according to our institutional guideline for CMV management, half-dose ganciclovir preemptive therapy (5 mg/kg once daily, 6 days/week) was administered to patients with CMV antigenemia levels <10/200,000 cells [39]. The requirement of ganciclovir induction therapy was observed in 8 (23.5%) patients with CMV antigenemia levels 10/200,000 cells.…”

Section: Complications and Neurological Statusmentioning

confidence: 99%

Favorable Outcome of Post-Transplantation Cyclophosphamide Haploidentical Peripheral Blood Stem Cell Transplantation with Targeted Busulfan-Based Myeloablative Conditioning Using Intensive Pharmacokinetic Monitoring in Pediatric Patients

Hong

Kang

Choi

et al. 2018

Biology of Blood and Marrow Transplantation

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Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with post-transplantation cyclophosphamide (PTCy) was performed previously in adults using a nonmyeloablative conditioning regimen and bone marrow as a graft source. In an effort to reduce relapse rates, myeloablative conditioning regimens with higher intensities are now used. We used an intensive daily pharmacokinetic monitoring method for busulfan dosing in children for effective myeloablation and to reduce toxicity. Here, we report the retrospective results of 34 patients (median age 11.1 years) who underwent haplo-HSCT with PTCy using a targeted busulfan-based myeloablative conditioning regimen and peripheral blood as a stem cell source. The donor-type neutrophil engraftment rate was 97.1%, and the cumulative incidence rates of grade II to IV and grade III to IV acute and extensive chronic graft-versus-host disease were 38.2%, 5.9%, and 9.1%, respectively. The overall survival and event-free survival rates, and treatment-related mortality were 85.0%, 79.4%, and 2.9%, respectively. Based on the subgroup analysis of patients with malignancies (n = 23), the relapse incidence rate was 21.7%. Haplo-HSCT using PTCy with targeted busulfan-based myeloablative conditioning and peripheral blood as a stem cell source was a safe and promising therapeutic option for children.

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“…The median number of neutrophil and platelet engraftment days was 14 (13–21 days) and 26 (13–87 days), respectively. With the exception of two, all patients experienced cytomegalovirus reactivation, which was treated by ganciclovir induction therapy who had cytomegalovirus antigenemia levels ≥ 10 per 100 000 cells ( n = 4) or half‐dose preemptive therapy ( n = 15) 22 . No patients showed cytomegalovirus disease or post‐transplantation lymphoproliferative disease.…”

Section: Resultsmentioning

confidence: 99%

Immunosenescent characteristics of T cells in young patients following haploidentical haematopoietic stem cell transplantation from parental donors

et al. 2020

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Half‐dose ganciclovir preemptive treatment of cytomegalovirus infection after pediatric allogeneic hematopoietic stem cell transplantation

Abstract: Half-dose GCV therapy at CMV antigenemia levels <10/200,000 cells is an effective and safe means of preemptively treating pediatric CMV infection after HSCT.

Cited by 14 publications

References 25 publications

Myeloablative conditioning regimens with combined of haploidentical and cord blood transplantation for myelodysplastic syndrome patients

Myeloablative conditioning regimens with combined of haploidentical and cord blood transplantation for myelodysplastic syndrome patients

Favorable Outcome of Post-Transplantation Cyclophosphamide Haploidentical Peripheral Blood Stem Cell Transplantation with Targeted Busulfan-Based Myeloablative Conditioning Using Intensive Pharmacokinetic Monitoring in Pediatric Patients

Immunosenescent characteristics of T cells in young patients following haploidentical haematopoietic stem cell transplantation from parental donors

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