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Ganciclovir-related neutropenia after preemptive therapy for cytomegalovirus infection: comparison between cord blood and bone marrow transplantation

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Abstract

We studied ganciclovir (GCV)-related neutropenia after preemptive therapy for cytomegalovirus infection: 9 of 17 (53%) cord blood transplantation (CBT) patients and 18 of 20 (90%) bone marrow transplantation (BMT) patients developed GCV-related neutropenia with an absolute neutrophil count (ANC) of less than 1000/μl. Among the patients who did not receive granulocyte colony-stimulating factor, 2 (13%) and 1 (7%) CBT patients, and 10 (56%) and 8 (44%) BMT patients, developed neutropenia with an ANC of less than 500 and 250/μl, respectively. The incidences of neutropenia in patients with an ANC of less than 1000, 500, and 250/μl were significantly lower after CBT in comparison with BMT. Two BMT patients, but no CBT patients, developed neutropenic fever, and both patients recovered after antibiotic therapy. In CBT patients, a creatinine clearance rate of less than 50 ml/min and an absence of steroid therapy were associated with a greater incidence of GCV-related neutropenia. No risk factors for GCV-related neutropenia were found in BMT patients. These results suggest that GCV may be less toxic to myeloid progenitor cells from cord blood than those from bone marrow.

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Acknowledgments

The authors thank Maki Monna-Oiwa for her secretarial assistance. We also thank the KOBAYASHI Foundation for financial support.

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Authors and Affiliations

  1. Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan

    Akira Tomonari, Tohru Iseki, Satoshi Takahashi, Jun Ooi, Toshiki Yamada, Kashiya Takasugi, Fumitaka Nagamura, Kaoru Uchimaru, Arinobu Tojo & Shigetaka Asano

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  1. Akira Tomonari
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  2. Tohru Iseki
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  3. Satoshi Takahashi
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  4. Jun Ooi
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  5. Toshiki Yamada
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  6. Kashiya Takasugi
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  7. Fumitaka Nagamura
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  8. Kaoru Uchimaru
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  9. Arinobu Tojo
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  10. Shigetaka Asano
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Correspondence to Akira Tomonari.

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Tomonari, A., Iseki, T., Takahashi, S. et al. Ganciclovir-related neutropenia after preemptive therapy for cytomegalovirus infection: comparison between cord blood and bone marrow transplantation. Ann Hematol 83, 573–577 (2004). https://doi.org/10.1007/s00277-004-0887-2

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  • DOI: https://doi.org/10.1007/s00277-004-0887-2

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