|
|
 Previous Article | Table of Contents | Next Article 
Neutropenia in Allogeneic Marrow Transplant Recipients Receiving Ganciclovir for Prevention of Cytomegalovirus Disease: Risk Factors and Outcome
Bernd Salzberger,
Raleigh A. Bowden,
Robert C. Hackman,
Chris Davis, and
Michael Boeckh
From the Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA.
To determine risk factors, frequency, time patterns, and outcome of ganciclovir-related neutropenia in allogeneic marrow transplant recipients, 278 consecutive patients receiving ganciclovir from engraftment until day 100 were studied. In this cohort, 159 patients (57%) had absolute neutrophil counts (ANC) less than 1,500/µL, 112 (41%) had an ANC less than 1,000/µL, 87 (31%) less than 750/µL, and 56 (21%) less than 500/µL for at least 2 consecutive days. Statistically significant risk factors for neutropenia in a Cox model were low marrow cellularity between day 21 and 28 (relative risk [RR] 2.4, P = .0002), hyperbilirubinemia  6 mg/dL during the first 20 days (RR 2.5, P = .0001), and elevation of serum creatinine 2 mg/dL after day 21 after transplant (RR 2.1, P = .001). Restriction to factors present at engraftment resulted in a similar model with low marrow cellularity, hyperbilirubinemia 6 mg/dL, and elevated serum creatinine as significant risk factors. Patients with no risk factor had an incidence of neutropenia of 21%, an incidence of 31% for one risk factor, and of 57% for two or more risk factors (RR 3.8, P = .001). Neutropenia was a negative predictor of overall (RR 2.0, P = .0001) and event-free survival (RR 2.1, P < .0001), and a predictor of relapse (RR 1.7, P = .03) and nonrelapse mortality (RR 2.1, P = .003). Thus, early liver dysfunction, elevated serum creatinine, and low marrow cellularity are risk factors for ganciclovir-related neutropenia. Neutropenia in ganciclovir recipients after marrow transplantation is an independent risk factor for mortality.
Blood, Vol. 90 No. 6 (September 15), 1997:
pp. 2502-2508
© 1997 by The American Society of Hematology.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
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]
|
|
|
|
|
|
|
S. B. Mossad
Agranulocytosis Induced by Nonchemotherapy Drugs
Ann Intern Med,
February 19, 2008;
148(4):
320 - 320.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. P. Iori, W. Arcese, F. Milano, E. Calabrese, G. F. Torelli, W. Barberi, M. G. Mascolo, L. De Felice, M. Screnci, B. Lucarelli, et al.
Unrelated cord blood transplant in children with high-risk acute lymphoblastic leukemia: a long-term follow-up
Haematologica,
August 1, 2007;
92(8):
1051 - 1058.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Einsele, P. Reusser, M. Bornhauser, P. Kalhs, G. Ehninger, H. Hebart, Y. Chalandon, N. Kroger, B. Hertenstein, F. Rohde, et al.
Oral valganciclovir leads to higher exposure to ganciclovir than intravenous ganciclovir in patients following allogeneic stem cell transplantation
Blood,
April 1, 2006;
107(7):
3002 - 3008.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. K. Burt, A. Traynor, L. Statkute, W. G. Barr, R. Rosa, J. Schroeder, L. Verda, N. Krosnjar, K. Quigley, K. Yaung, et al.
Nonmyeloablative Hematopoietic Stem Cell Transplantation for Systemic Lupus Erythematosus
JAMA,
February 1, 2006;
295(5):
527 - 535.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Norasetthada, K. Kirby, B. Sandmaier, D. Maloney, M. Maris, C. Davis, L. Corey, R. Storb, and M. Boeckh
CMV Infection and Disease after Nonmyeloablative (NM) HCT Revisited: Incidence, Risk Factors, Ganciclovir-Related Neutropenia and Outcome.
Blood (ASH Annual Meeting Abstracts),
November 16, 2005;
106(11):
3247 - 3247.
[Abstract]
|
|
|
|
|
|
|
M. Boeckh and W. G. Nichols
The impact of cytomegalovirus serostatus of donor and recipient before hematopoietic stem cell transplantation in the era of antiviral prophylaxis and preemptive therapy
Blood,
March 15, 2004;
103(6):
2003 - 2008.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Bittencourt, V. Rocha, S. Chevret, G. Socie, H. Esperou, A. Devergie, L. Dal Cortivo, J.-P. Marolleau, F. Garnier, P. Ribaud, et al.
Association of CD34 cell dose with hematopoietic recovery, infections, and other outcomes after HLA-identical sibling bone marrow transplantation
Blood,
April 15, 2002;
99(8):
2726 - 2733.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Ljungman, R. de la Camara, N. Milpied, L. Volin, C. A. Russell, A. Crisp, A. Webster, and Valacyclovir International Bone Marrow Transplant
Randomized study of valacyclovir as prophylaxis against cytomegalovirus reactivation in recipients of allogeneic bone marrow transplants
Blood,
April 15, 2002;
99(8):
3050 - 3056.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Reusser, H. Einsele, J. Lee, L. Volin, M. Rovira, D. Engelhard, J. Finke, C. Cordonnier, H. Link, and P. Ljungman
Randomized multicenter trial of foscarnet versus ganciclovir for preemptive therapy of cytomegalovirus infection after allogeneic stem cell transplantation
Blood,
February 15, 2002;
99(4):
1159 - 1164.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Weissinger, B. M. Sandmaier, D. G. Maloney, W. I. Bensinger, T. Gooley, and R. Storb
Decreased transfusion requirements for patients receiving nonmyeloablative compared with conventional peripheral blood stem cell transplants from HLA-identical siblings
Blood,
December 15, 2001;
98(13):
3584 - 3588.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. G. Nichols, L. Corey, T. Gooley, W. L. Drew, R. Miner, M.-L. Huang, C. Davis, and M. Boeckh
Rising pp65 antigenemia during preemptive anticytomegalovirus therapy after allogeneic hematopoietic stem cell transplantation: risk factors, correlation with DNA load, and outcomes
Blood,
February 15, 2001;
97(4):
867 - 874.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Ljungman, G. L. Deliliers, U. Platzbecker, S. Matthes-Martin, A. Bacigalupo, H. Einsele, J. Ullmann, M. Musso, R. Trenschel, P. Ribaud, et al.
Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients
Blood,
January 15, 2001;
97(2):
388 - 392.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Management of herpes virus infections following transplantation
J. Antimicrob. Chemother.,
June 1, 2000;
45(6):
729 - 748.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. E. C. Broers, R. van der Holt, J. W. J. van Esser, J.-W. Gratama, S. Henzen-Logmans, V. Kuenen-Boumeester, B. Lowenberg, and J. J. Cornelissen
Increased transplant-related morbidity and mortality in CMV-seropositive patients despite highly effective prevention of CMV disease after allogeneic T-cell-depleted stem cell transplantation
Blood,
April 1, 2000;
95(7):
2240 - 2245.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Q. Sun, K. E. Pollok, R. L. Burton, L. J. Dai, W. Britt, D. J. Emanuel, and K. G. Lucas
Simultaneous Ex Vivo Expansion of Cytomegalovirus and Epstein-Barr Virus-Specific Cytotoxic T Lymphocytes Using B-Lymphoblastoid Cell Lines Expressing Cytomegalovirus pp65
Blood,
November 1, 1999;
94(9):
3242 - 3250.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T.N. Small, E.B. Papadopoulos, F. Boulad, P. Black, H. Castro-Malaspina, B.H. Childs, N. Collins, A. Gillio, D. George, A. Jakubowski, et al.
Comparison of Immune Reconstitution After Unrelated and Related T-Cell-Depleted Bone Marrow Transplantation: Effect of Patient Age and Donor Leukocyte Infusions
Blood,
January 15, 1999;
93(2):
467 - 480.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Boeckh and G. Boivin
Quantitation of Cytomegalovirus: Methodologic Aspects and Clinical Applications
Clin. Microbiol. Rev.,
July 1, 1998;
11(3):
533 - 554.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
