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Blood, 15 February 2008, Vol. 111, No. 4, pp. 1816-1819. Prepublished online as a Blood First Edition Paper on November 26, 2007; DOI 10.1182/blood-2007-03-080010. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-03-080010v1 111/4/1816    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by O'Brien, S. Articles by Keating, M. Search for Related Content PubMed PubMed Citation Articles by O'Brien, S. Articles by Keating, M. Related Collections Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Valganciclovir prevents cytomegalovirus reactivation in patients receiving alemtuzumab-based therapy Susan O'Brien1, Farhad Ravandi1, Todd Riehl2, William Wierda1, Xuelin Huang3, Jeffrey Tarrand2, Brandi O'Neal1, Hagop Kantarjian1, and Michael Keating1 Departments of1 Leukemia, 2 Laboratory Medicine, and 3 Biostatistics and Applied Mathematics, University of Texas M. D. Anderson Cancer Center, Houston Alemtuzumab is an immunosuppressive antibody that depletes normal T cells and B cells. Prophylaxis for herpes virus and Pneumocystis carinii is standard with this agent. Approximately 20% to 25% of patients will experience cytomegalovirus (CMV) reactivation. We conducted a randomized trial wherein patients being treated with an alemtuzumab-containing regimen received prophylaxis with either valaciclovir 500 mg orally daily or valganciclovir 450 mg orally twice daily. The study design planned to enroll 128 patients, but stopping rules for early termination were met. Forty patients were evaluable. Median age was 58 years (range, 25–83 years); median number of prior therapies was 2 (range, 0–10). Diagnoses included chronic lymphocytic leukemia (29), T-cell prolymphocytic leukemia (3), hairy cell leukemia (1), adult T-cell leukemia/lymphoma (ATLL) (1), marginal zone leukemia (1), large granular lymphocyte leukemia (2), acute lymphoblastic leukemia (1), and T-cell lymphoma (2). Patients received various alemtuzumab-containing regimens, including single agent (5) or combined with: rituximab (2), pentostatin (6), fludarabine, cyclophosphamide, and rituximab (23), or fractionated cyclophosphamide, vincristine, adriamycin, and dexamethasone (hyper-CVAD) (4). Seven of 20 patients enrolled on the valaciclovir arm experienced CMV reactivation. None of the 20 patients randomized to valganciclovir experienced CMV reactivation (P = .004). In conclusion, this agent was highly effective for prophylaxis of CMV reactivation in patients receiving alemtuzumab. This trial was registered at www.ClinicalTrials.gov as #NCT00562770 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Valganciclovir versus valaciclovir for prevention of alemtuzumab-induced cytomegalovirus reactivation: what are the implications for routine clinical practice? Lukas Smolej Blood 2008 112: 2167. [Full Text] [PDF] This article has been cited by other articles: F. Ravandi, A. Aribi, S. O'Brien, S. Faderl, D. Jones, A. Ferrajoli, X. Huang, S. York, S. Pierce, W. Wierda, et al. Phase II Study of Alemtuzumab in Combination With Pentostatin in Patients With T-Cell Neoplasms J. Clin. Oncol., November 10, 2009; 27(32): 5425 - 5430. [Abstract] [Full Text] [PDF] M. Boeckh and P. Ljungman How we treat cytomegalovirus in hematopoietic cell transplant recipients Blood, June 4, 2009; 113(23): 5711 - 5719. [Abstract] [Full Text] [PDF] L. Smolej Valganciclovir versus valaciclovir for prevention of alemtuzumab-induced cytomegalovirus reactivation: what are the implications for routine clinical practice? Blood, September 1, 2008; 112(5): 2167 - 2167. [Full Text] [PDF]

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