Journal ArticleDOI
A controlled trial of ganciclovir to prevent cytomegalovirus disease after heart transplantation.
Thomas C. Merigan,Dale G. Renlund,Susan Keay,Michael R. Bristow,Vaughn A. Starnes,John B. O'Connell,Silvia Resta,Diane Dunn,P. Gamberg,Ranae M. Ratkovec,Wayne E. Richenbacher,Roger C. Millar,Charles DuMond,Bernadette DeAmond,Veronica Sullivan,Tricia Cheney,William Buhles,Edward B. Stinson +17 more
TLDR
The prophylactic administration of ganciclovir after heart transplantation is safe, and inCMV-seropositive patients it reduces the incidence of CMV-induced illness.Abstract:
Background. Because of the immunosuppression required, heart-transplant recipients frequently have complications caused by cytomegalovirus (CMV), including pneumonia, esophagitis, gastritis, and a syndrome of fever, hepatitis, and leukopenia. We undertook a controlled trial to evaluate the prophylactic administration of ganciclovir to prevent CMV-induced disease after heart transplantation. Methods. This randomized, double-blind, placebo-controlled trial was conducted at four centers. Before randomization, the patients were stratified into two groups: those who were seropositive for CMV before transplantation and those who were seronegative but who received hearts from seropositive donors. Ganciclovir was given intravenously at a dose of 5 mg per kilogram of body weight every 12 hours from postoperative day 1 through day 14, then at a dose of 6 mg per kilogram each day for 5 days per week until day 28. Results. Among the seropositive patients, CMV illness occurred during the first 120 days after ...read more
Citations
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Journal ArticleDOI
Management of fever in patients with cancer and treatment-induced neutropenia.
TL;DR: The importance of neutropenia in the risk of serious infection in patients with cancer who are receiving cytotoxic chemotherapy and those with bone marrow failure or human immunodeficiency virus (HIV) infection was first recognized nearly 30 years ago.
Journal ArticleDOI
Ganciclovir prophylaxis to prevent cytomegalovirus disease after allogeneic marrow transplant
James M. Goodrich,Raleigh A. Bowden,Lloyd D. Fisher,Claire Keller,Gary Schoch,Joel D. Meyers +5 more
TL;DR: A randomized placebo-controlled trial of ganciclovir given to CMV-seropositive allogeneic marrow transplant recipients at the time of engraftment and before CMV excretion or disease is performed, which shows an advantage of this prophylaxis strategy, compared with early treatment strategies.
Journal ArticleDOI
Infections in solid-organ transplant recipients.
Robin Patel,Carlos V. Paya +1 more
TL;DR: Fungal infections, caused by both yeasts and mycelial fungi, are associated with the highest mortality rates, and mycobacterial, pneumocystis, and parasitic diseases may also occur.
Journal ArticleDOI
Recovery of HLA-restricted cytomegalovirus (CMV)-specific T-cell responses after allogeneic bone marrow transplant: correlation with CMV disease and effect of ganciclovir prophylaxis.
TL;DR: Evaluated reconstitution of CMV-specific T-cell responses in 47 bone marrow transplant (BMT) recipients and suggest that a delay in recovery of these responses as a result of ganciclovir prophylaxis may contribute to the occurrence of late CMV disease.
Journal ArticleDOI
Randomised trial of efficacy and safety of oral ganciclovir in the prevention of cytomegalovirus disease in liver-transplant recipients
Edward Gane,Faouzi Saliba,Garcia Jc Valdecasas,John O'Grady,Mark D. Pescovitz,Susan Lyman,Charles A. Robinson +6 more
TL;DR: Oral ganciclovir is a safe and effective method for the prevention of CMV disease after orthotopic liver transplantation and also reduced symptomatic herpes-simplex infections.
References
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Journal ArticleDOI
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TL;DR: The overall size of the procedure is shown to be controlled with virtually the same accuracy as the single sample chi-square test based on N(m1 + m2) observations and the power is found to bevirtually the same.
Journal ArticleDOI
A randomized, controlled trial of prophylactic ganciclovir for cytomegalovirus pulmonary infection in recipients of allogeneic bone marrow transplants; The City of Hope-Stanford-Syntex CMV Study Group.
TL;DR: A controlled trial of ganciclovir in recipients of bone marrow transplants who had asymptomatic pulmonary CMV infection and sought to identify risk factors for the development of CMV interstitial pneumonia.
Journal ArticleDOI
Treatment of Cytomegalovirus Pneumonia with Ganciclovir and Intravenous Cytomegalovirus Immunoglobulin in Patients with Bone Marrow Transplants
Elizabeth Cecile Reed,Raleigh A. Bowden,Paula S. Dandliker,Kathryn E. Lilleby,Joel D. Meyers +4 more
TL;DR: Survival of 13 of 25 patients from the initial episode of cytomegalovirus pneumonia with the regimen of ganciclovir and cytomeGalovirus immunoglobulin is significantly better (P less than 0.001) than the survival of13 of 89 patients using previous antiviral regimens.
Journal ArticleDOI
Cytomegalovirus Pneumonia after Bone Marrow Transplantation Successfully Treated with the Combination of Ganciclovir and High-Dose Intravenous Immune Globulin
David Emanuel,I Cunningham,Kethy Jules-Elysee,Joel A. Brochstein,Nancy A. Kernan,Joseph Laver,Diane E. Stover,Dorothy A. White,Anna O. S. Fels,Bruce Polsky,Hugo Castro-Malaspina,Joanne Peppard,Patricia Bartus,Ulrich Hämmerling,Richard J. O'Reilly +14 more
TL;DR: Ganciclovir, when combined with high-dose intravenous immune globulin, appears to have significantly altered the outcome of patients with cytomegalovirus pneumonia after allogeneic bone marrow transplantation.
Journal ArticleDOI
Antiviral activity and mechanism of action of ganciclovir.
TL;DR: The selective antiviral response associated with ganciclovir treatment is achieved because of the much weaker inhibition of cellular DNA polymerases by ganco-5'-triphosphate-TP.