The Role Of Acyclovir For Prevention Of Cytomegalovirus Infection After Stem Cell Transplantation In Children

Objective: To investigate the efficacy and safety of acyclovir in preventing CMV infection after stem cell transplantation.Method: During the admit in hospital there was conformed no CMV infection(DNA <5.0 × 102),start taking Acyclovir Sustained Release Tablets,weighting 10 ~ 14kg: 0.2g,two times a day;the weight of 15 to 25kg: 0.2g,three times a day;body weight >25kg: 0.4g,two times a day.taking acyclovir 3days in a week having a gap of 4 days.Patients who were not in the same period of stem cell transplantation were not included in the control group.Two groups of patients were treated with compound sulfamethoxazole,three days a week for a period of four days to prevent infection of bacterial.The DNA infection rate of serum CMV virus >5.0 × 102 was evaluated as CMV infection,and the infection rate of CMV was higher than that of the two groups.The safety indexes included: blood hemoglobin,WBC and platelet after transplantation,chimerism rate of stem cells,liver function,renal function and so on.Results: There were 20 cases in the experimental group,and were followed up to 12 months,except one patien(5.0%)was found to be infected with CMV(DNA =1.9×104/ml)in all the patients.There were 22 cases of infection(55.0%)in the non prophylactic group,and 15(62.8%)of the CMV infection occurred within the first 90 days after transplantation,among which the typical CMV pneumonia was found in 2 cases.There was no significant difference in Hb,WBC,NEU and Plt between the two groups.There was no significant difference between the two groups in the rate of stem cell engraftment.2 cases of patients with CMV infection when the use of Acyclovir Sustained Release Tablets treatment is not effective,need to change the use of intravenous ganciclovir.There was no significant difference in liver function and renal function between the two groups.Conclusion: It is effective and safe to prevent CMV infection by long-term oral administration of Acyclovir Sustained Release Tablets after stem cell transplantation.1)can significantly reduce the infection rate of CMV;2)there was no effect on the engraftment rate of transplanted stem cells;(3)there was no significant effect on the hematological indexes after transplantation;4)there was no effect on the liver and kidney function.