High dose valacyclovir for cytomegalovirus prophylaxis following allogeneic hematopoietic cell transplantation.
INTRODUCTION: Cytomegalovirus (CMV) is one of the most common and clinically significant viral infections following allogeneic hematopoietic cell transplantation (HCT). Currently available options for CMV prophylaxis and treatment present challenges related to side effects and cost.
METHODS: In this retrospective medical record review, the incidence of clinically significant CMV infection (CMV disease or reactivation requiring preemptive treatment) following allogeneic HCT was compared in patients receiving valacyclovir 1 g three times daily versus acyclovir 400 mg every 12 h for viral prophylaxis.
RESULTS: Forty-five patients who received valacyclovir were matched based on propensity scoring to 35 patients who received acyclovir. All patients received reduced-intensity conditioning regimens containing anti-thymocyte globulin. Clinically significant CMV infection by day + 180 was lower in the valacyclovir group compared to the acyclovir group (18% vs. 57%,
CONCLUSION: Prospective evaluation of valacyclovir 1 g three times daily for viral prophylaxis following allogeneic HCT is warranted. Due to valacyclovir's favorable toxicity profile and affordable cost, it has the potential to benefit patients on a broad scale as an option for CMV prophylaxis.
Published In/Presented At
Hawks, K. G., Fegley, A., Sabo, R. T., Roberts, C. H., & Toor, A. A. (2023). High dose valacyclovir for cytomegalovirus prophylaxis following allogeneic hematopoietic cell transplantation. Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners, 29(1), 130–137. https://doi.org/10.1177/10781552211060479
Medicine and Health Sciences
Department of Medicine, Hematology-Medical Oncology Division