This was a retrospective chart review of 33 CMV seropositive patients that underwent UCBT. The intensive prevention strategy in UCBT consisted of ganciclovir 5 mg/kg/d intravenously or valganciclovir 900 mg by mouth daily initiated at the beginning of the conditioning regimen until Day −2. Then from Day −1 to Day +100, patients received valacyclovir 2 g by mouth three times daily, and from Day +101 to Day +365, acyclovir 800 mg by mouth twice daily. Historical standard prevention was acyclovir 800 mg by mouth twice daily initiated at the beginning of the conditioning regimen until Day +365.
Thirty-three patients were included from 2008 to 2014. There were no differences in the adverse effects experienced between the two regimens (p = .4). CMV reactivation occurred significantly later with intensive prevention (p = .003). The median CMV viral titer at reactivation was lower in the intensive versus the historic prevention (1,800 copies/mL and 2,700 copies/mL, respectively), but was not significantly different. CMV disease occurred significantly less often in the intensive group (p = .039).
The results from this study indicate that the intensive prevention strategy was well tolerated, significantly delayed CMV reactivation, and patients had less CMV disease.
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