ABSTRACT A retrospective single center study was performed to evaluate the safety and efficacy of valacyclovir for prevention of cytomegalovirus (CMV) infection (reactivation) after

allogeneic stem cell transplantation (SCT). We compared a group of 31 patients at risk for CMV reactivation (donor, recipient or both seropositive for CMV) who received valacyclovir at an

oral dose of 1 g three times a day for CMV prophylaxis with a matched cohort of 31 patients who did not receive the drug or any other form of CMV prophylaxis. Valacyclovir was used as

primary prophylaxis in 12 patients and as secondary prophylaxis (after a prior CMV reactivation was effectively treated with either ganciclovir or foscarnet and without CMV antigenemia at

prophylaxis, 3/12 patients who received valacyclovir reactivated CMV compared to 24/31 patients in the control group (_P_ < 0.001). For secondary prophylaxis, 5/19 valacyclovir patients

reactivated compared to 16/24 control patients (_P_ < 0.05). Valacyclovir was well tolerated except for infrequent and mild gastrointestinal side-effects. There was no difference in the

incidence of CMV disease in the two groups. Prophylaxis with valacyclovir appears to be safe and efficacious in preventing both primary and secondary CMV reactivation in at-risk patients

after allogeneic SCT. Larger prospective randomized studies will be required to confirm these observations. _Bone Marrow Transplantation_ (2001) 28, 265–270. Access through your institution

Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and

online access $259.00 per year only $21.58 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes

which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY

OTHERS EFFICACY OF PROPHYLACTIC LETERMOVIR FOR CYTOMEGALOVIRUS REACTIVATION IN HEMATOPOIETIC CELL TRANSPLANTATION: A MULTICENTER REAL-WORLD DATA Article 02 November 2020 LETERMOVIR FOR

CYTOMEGALOVIRUS INFECTION IN PEDIATRIC PATIENTS UNDERGOING ALLOGENIC HEMATOPOIETIC STEM CELL TRANSPLANTATION: A REAL-LIFE STUDY BY THE INFECTIOUS DISEASES WORKING GROUP OF ITALIAN

ASSOCIATION OF PEDIATRIC HEMATOLOGY-ONCOLOGY (AIEOP) Article 25 January 2024 HIGH-DOSE ACICLOVIR IN CMV INFECTION PROPHYLAXIS AFTER ALLOGENEIC HSCT: A SINGLE-CENTER LONG-TERM EXPERIENCE

Article Open access 23 August 2023 REFERENCES * Wingard JR . Infections in allogeneic bone marrow transplant recipients _Semin Oncol_ 1993 20: 80–87 CAS  PubMed  Google Scholar  * Winston

DJ, Ho WG, Champlin RE . Cytomegalovirus infections after allogeneic bone marrow transplantation _Rev Infect Dis_ 1990 12: S776–S792 Article  PubMed  Google Scholar  * Osarogiagbon RU, Defor

TE, Weisdorf MA _et al_. CMV antigenemia following bone marrow transplantation: risk factors and outcomes _Biol Blood Marrow Transplant_ 2000 6: 280–288 Article  CAS  PubMed  Google Scholar

  * Humar A, Wood S, Lipton J _et al_. Effect of cytomegalovirus infection on 1-year mortality rates among recipients of allogeneic bone marrow transplants _Clin Infect Dis_ 1998 26: 606–610

Article  CAS  PubMed  Google Scholar  * Maltezou H, Whimbey E, Abi-Said D _et al_. Cytomegalovirus disease in adult marrow transplant recipients receiving ganciclovir prophylaxis: a

retrospective study _Bone Marrow Transplant_ 1999 24: 665–669 Article  CAS  PubMed  Google Scholar  * Goodrich JM, Bowden RA, Fisher L _et al_. Ganciclovir prophylaxis to prevent

cytomegalovirus disease after allogeneic marrow transplant _Ann Intern Med_ 1993 118: 173–178 Article  CAS  PubMed  Google Scholar  * Mori T, Okamoto S, Matsuoka S _et al_. Risk-adapted

pre-emptive therapy for cytomegalovirus disease in patients undergoing allogeneic bone marrow transplantation _Bone Marrow Transplant_ 2000 25: 765–769 Article  CAS  PubMed  Google Scholar 

* Winston DJ, Ho WG, Bartoni K _et al_. Ganciclovir prophylaxis of cytomegalovirus infection and disease in allogeneic bone marrow transplant recipients. Results of a placebo-controlled,

double-blind trial _Ann Intern Med_ 1993 118: 179–184 Article  CAS  PubMed  Google Scholar  * Bacigalupo A, Tedone E, Van Lint MT _et al_. CMV prophylaxis with foscarnet in allogeneic bone

marrow transplant recipients at high risk of developing CMV infections _Bone Marrow Transplant_ 1994 13: 783–788 CAS  PubMed  Google Scholar  * Prentice HG, Gluckman E, Powles RL _et al_.

Long-term survival in allogeneic bone marrow transplant recipients following acyclovir prophylaxis for CMV infection. The European Acyclovir for CMV Prophylaxis Study Group _Bone Marrow

Transplant_ 1997 19: 129–133 Article  CAS  PubMed  Google Scholar  * Meyers JD, Reed EC, Shepp DH _et al_. Acyclovir for prevention of cytomegalovirus infection and disease after allogeneic

marrow transplantation _New Engl J Med_ 1988 318: 70–75 Article  CAS  PubMed  Google Scholar  * Boeckh M, Gooley TA, Bowden RA . Effect of high-dose acyclovir on survival in allogeneic

marrow transplant recipients who received ganciclovir at engraftment or for cytomegalovirus pp65 antigenemia _J Infect Dis_ 1998 178: 1153–1157 Article  CAS  PubMed  Google Scholar  * Weller

S, Blum MR, Doucette M _et al_. Pharmacokinetics of the acyclovir pro-drug valaciclovir after escalating single- and multiple-dose administration to normal volunteers _Clin Pharmacol Ther_

1993 54: 595–605 Article  CAS  PubMed  Google Scholar  * Purifoy DJ, Beauchamp LM, de Miranda P _et al_. Review of research leading to new anti-herpesvirus agents in clinical development:

valaciclovir hydrochloride (256U, the L-valyl ester of acyclovir) and 882C, a specific agent for varicella zoster virus _J Med Virol_ 1993 (Suppl. 1) 139–145 Article  Google Scholar  *

Soul-Lawton J, Seaber E, On N _et al_. Absolute bioavailability and metabolic disposition of valaciclovir, the L-valyl ester of acyclovir, following oral administration to humans _Antimicrob

Agents Chemother_ 1995 39: 2759–2764 Article  CAS  PubMed  PubMed Central  Google Scholar  * Lowance D, Neumayer HH, Legendre CM _et al_. Valacyclovir for the prevention of cytomegalovirus

disease after renal transplantation. International Valacyclovir Cytomegalovirus Prophylaxis Transplantation Study Group _New Engl J Med_ 1999 340: 1462–1470 Article  CAS  PubMed  Google

Scholar  * Himmelmann-Jud B, Wuthrich RP, Weinreich T, Binswanger U . Successful use of oral valacyclovir in post-transplant cytomegalovirus infection in renal allograft recipients _Nephrol

Dial Transplant_ 1998 13: 1326–1327 Article  CAS  PubMed  Google Scholar  * Emery VC, Sabin C, Feinberg JE _et al_. Quantitative effects of valacyclovir on the replication of cytomegalovirus

(CMV) in persons with advanced human immunodeficiency virus disease: baseline CMV load dictates time to disease and survival. The AIDS Clinical Trials Group 204/Glaxo Wellcome 123–014

International CMV Prophylaxis Study Group _J Infect Dis_ 1999 180: 695–701 Article  CAS  PubMed  Google Scholar  * Feinberg JE, Hurwitz S, Cooper D _et al_. A randomized, double-blind trial

of valaciclovir prophylaxis for cytomegalovirus disease in patients with advanced human immunodeficiency virus infection. AIDS Clinical Trials Group Protocol 204/Glaxo Wellcome 123–014

International CMV Prophylaxis Study Group _J Infect Dis_ 1998 177: 48–56 Article  CAS  PubMed  Google Scholar  * Landry ML, Ferguson D, Stevens-Ayers T _et al_. Evaluation of CMV Brite kit

for detection of cytomegalovirus pp65 antigenemia in peripheral blood leukocytes by immunofluorescence _J Clin Microbiol_ 1996 34: 1337–1339 CAS  PubMed  PubMed Central  Google Scholar  *

Salzberger B, Bowden RA, Hackman RC _et al_. Neutropenia in allogeneic marrow transplant recipients receiving ganciclovir for prevention of cytomegalovirus disease: risk factors and outcome

_Blood_ 1997 90: 2502–2508 CAS  PubMed  Google Scholar  * Boeckh M, Gooley TA, Myerson D _et al_. Cytomegalovirus pp65 antigenemia-guided early treatment with ganciclovirversus ganciclovir

at engraftment after allogeneic marrow transplantation: a randomized double-blind study _Blood_ 1996 88: 4063–4071 CAS  PubMed  Google Scholar  Download references AUTHOR INFORMATION AUTHORS

AND AFFILIATIONS * Division of Hematology and Oncology, Department of Medicine, Vanderbilt University School of Medicine and VA Medical Center, Nashville, TN, USA M Vusirikala, SN Wolff, RS

Stein, SJ Brandt, DS Morgan, JP Greer, FG Schuening & SA Goodman * Department of Medicine, and the Division of Infectious Diseases, Department of Medicine, Vanderbilt University School

of Medicine and VA Medical Center, Nashville, TN, USA JS Dummer Authors * M Vusirikala View author publications You can also search for this author inPubMed Google Scholar * SN Wolff View

author publications You can also search for this author inPubMed Google Scholar * RS Stein View author publications You can also search for this author inPubMed Google Scholar * SJ Brandt

View author publications You can also search for this author inPubMed Google Scholar * DS Morgan View author publications You can also search for this author inPubMed Google Scholar * JP

Greer View author publications You can also search for this author inPubMed Google Scholar * FG Schuening View author publications You can also search for this author inPubMed Google Scholar

* JS Dummer View author publications You can also search for this author inPubMed Google Scholar * SA Goodman View author publications You can also search for this author inPubMed Google

Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Vusirikala, M., Wolff, S., Stein, R. _et al._ Valacyclovir for the prevention of cytomegalovirus

infection after allogeneic stem cell transplantation: a single institution retrospective cohort analysis. _Bone Marrow Transplant_ 28, 265–270 (2001). https://doi.org/10.1038/sj.bmt.1703129

Download citation * Received: 18 December 2000 * Accepted: 16 May 2001 * Published: 04 September 2001 * Issue Date: 01 August 2001 * DOI: https://doi.org/10.1038/sj.bmt.1703129 SHARE THIS

ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard

Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * cytomegalovirus * valacyclovir * allogeneic SCT