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Article: Cidofovir for the treatment of adenoviral infection in pediatric hematopoietic stem cell transplant patients

TitleCidofovir for the treatment of adenoviral infection in pediatric hematopoietic stem cell transplant patients
Authors
KeywordsCidofovir
Adenovirus
Hematopoietic stem cell transplantation
Issue Date2006
Citation
Transplantation, 2006, v. 81, n. 10, p. 1398-1404 How to Cite?
AbstractBACKGROUND. Adenovirus (ADV) infections are associated with significant morbidity and mortality after hematopoietic stem cell transplantation (HSCT). The virus is endemic in the general pediatric population and frequently causes severe disease in immunocompromised patients, especially children. We report our experience with cidofovir (CDV) for treatment of ADV infection in 57 HSCT patients, median age 8 years (range 0.5-26). METHODS. Peripheral blood was prospectively screened weekly on all patients for ADV by quantitative real-time PCR for the first 100 days post-HSCT or longer if clinically indicated. Cultures for viral pathogens were performed from other involved sites. Upon detection of ADV by PCR, culture or tissue histopathology, CDV was given intravenously at 5 mg/kg weekly for 2 consecutive weeks, then every 2 weeks until 3 consecutive ADV-negative samples were documented from all previously invoved sites. RESULTS. The clinical manifestations of ADV infection were: diarrhea (53%), fever (21%), hemorrhagic cystitis (12%), and pneumonitis (11%). Eight patients (14%) presented with disseminated disease. CDV treatment resulted in complete resolution of clinical symptoms in 56 (98%) patients in whom the virus became undetectable by all methods. One patient died due to ADV pneumonitis. No cases of dose-limiting nephrotoxicity were observed. CONCLUSIONS. Cidofovir appeared safe and effective for the treatment of ADV infection in this predominantly pediatric HSCT population. Vigilant surveillance and early treatment with CDV can prevent the poor outcomes associated with ADV disease. A larger prospective study is needed to further determine the role of CDV in the treatment of ADV after HSCT. Copyright © 2006 by Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/294414
ISSN
2023 Impact Factor: 5.3
2023 SCImago Journal Rankings: 1.371
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYusuf, Usman-
dc.contributor.authorHale, Gregory A.-
dc.contributor.authorCarr, Jeanne-
dc.contributor.authorGu, Zhengming-
dc.contributor.authorBenaim, Ely-
dc.contributor.authorWoodard, Paul-
dc.contributor.authorKasow, Kimberly A.-
dc.contributor.authorHorwitz, Edwin M.-
dc.contributor.authorLeung, Wing-
dc.contributor.authorSrivastava, Deo Kumar-
dc.contributor.authorHandgretinger, Rupert-
dc.contributor.authorHayden, Randall T.-
dc.date.accessioned2020-12-03T08:22:41Z-
dc.date.available2020-12-03T08:22:41Z-
dc.date.issued2006-
dc.identifier.citationTransplantation, 2006, v. 81, n. 10, p. 1398-1404-
dc.identifier.issn0041-1337-
dc.identifier.urihttp://hdl.handle.net/10722/294414-
dc.description.abstractBACKGROUND. Adenovirus (ADV) infections are associated with significant morbidity and mortality after hematopoietic stem cell transplantation (HSCT). The virus is endemic in the general pediatric population and frequently causes severe disease in immunocompromised patients, especially children. We report our experience with cidofovir (CDV) for treatment of ADV infection in 57 HSCT patients, median age 8 years (range 0.5-26). METHODS. Peripheral blood was prospectively screened weekly on all patients for ADV by quantitative real-time PCR for the first 100 days post-HSCT or longer if clinically indicated. Cultures for viral pathogens were performed from other involved sites. Upon detection of ADV by PCR, culture or tissue histopathology, CDV was given intravenously at 5 mg/kg weekly for 2 consecutive weeks, then every 2 weeks until 3 consecutive ADV-negative samples were documented from all previously invoved sites. RESULTS. The clinical manifestations of ADV infection were: diarrhea (53%), fever (21%), hemorrhagic cystitis (12%), and pneumonitis (11%). Eight patients (14%) presented with disseminated disease. CDV treatment resulted in complete resolution of clinical symptoms in 56 (98%) patients in whom the virus became undetectable by all methods. One patient died due to ADV pneumonitis. No cases of dose-limiting nephrotoxicity were observed. CONCLUSIONS. Cidofovir appeared safe and effective for the treatment of ADV infection in this predominantly pediatric HSCT population. Vigilant surveillance and early treatment with CDV can prevent the poor outcomes associated with ADV disease. A larger prospective study is needed to further determine the role of CDV in the treatment of ADV after HSCT. Copyright © 2006 by Lippincott Williams & Wilkins.-
dc.languageeng-
dc.relation.ispartofTransplantation-
dc.subjectCidofovir-
dc.subjectAdenovirus-
dc.subjectHematopoietic stem cell transplantation-
dc.titleCidofovir for the treatment of adenoviral infection in pediatric hematopoietic stem cell transplant patients-
dc.typeArticle-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1097/01.tp.0000209195.95115.8e-
dc.identifier.pmid16732176-
dc.identifier.scopuseid_2-s2.0-33744924744-
dc.identifier.volume81-
dc.identifier.issue10-
dc.identifier.spage1398-
dc.identifier.epage1404-
dc.identifier.isiWOS:000237822800008-
dc.identifier.issnl0041-1337-

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