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Randomized Comparison of Oral Valacyclovir and Intravenous Ganciclovir for Prevention of Cytomegalovirus Disease after Allogeneic Bone Marrow Transplantation

Drew J. Winston, Andrew M. Yeager, Pranatharthi H. Chandrasekar, David R. Snydman, Finn Bo Petersen, Mary C. Territo and The Valacyclovir Cytomegalovirus Study Group
Clinical Infectious Diseases
Vol. 36, No. 6 (Mar. 15, 2003), pp. 749-758
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/4462397
Page Count: 10
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Randomized Comparison of Oral Valacyclovir and Intravenous Ganciclovir for Prevention of Cytomegalovirus Disease after Allogeneic Bone Marrow Transplantation
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Abstract

In this multicenter, randomized study, cytomegalovirus (CMV)-seropositive patients who received an allogeneic bone marrow transplant were provided high-dose intravenous acyclovir (500 mg/m² q8h) from the day of transplantation until engraftment. The patients were then randomly assigned to receive either oral valacyclovir, 2 g q.i.d. (n = 83), or intravenous ganciclovir, 5 mg/kg q12h for 1 week, then 6 mg/kg once daily for 5 days per week (n = 85), until day 100 after transplantation. CMV infection occurred in 12% of the patients who received valacyclovir and in 19% of the patients who received ganciclovir (hazard ratio [HR], 1.042; 95% confidence interval [CI], 0.391-2.778; P = .934). CMV disease developed in only 2 patients who received valacyclovir and in 1 patient who received ganciclovir (HR, 1.943; 95% CI, 0.176-21.44; P = .588). Oral valacyclovir can be an effective alternative to intravenous ganciclovir for prophylaxis of CMV disease after bone marrow transplantation.

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