Universität zu Köln

Stern, Anat ORCID: 0000-0002-8659-8108, Alonso, Carolyn D., Garcia-Vidal, Carolina, Cardozo, Celia, Slavin, Monica ORCID: 0000-0002-8443-314X, Yong, Michelle K., Ho, Su Ann, Steinke, Seema Mehta, Avery, Robin K., Koehler, Philipp ORCID: 0000-0002-7386-7495, Scheid, Christof, Cornely, Oliver A., Maertens, Johan, Aad, Yasmine Abi, Epstein, David J., Papanicolaou, Genovefa A. and Neofytos, Dionysios (2021). Safety and efficacy of intravenously administered cidofovir in adult haematopoietic cell transplant recipients: a retrospective multicentre cohort study. J. Antimicrob. Chemother., 76 (11). S. 3020 - 3029. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

Objectives: To evaluate the safety and efficacy of cidofovir for the treatment of double-stranded DNA (dsDNA) viral infections following allogeneic haematopoietic cell transplant (HCT). Methods: This was a retrospective multicentre cohort study including adult HCT recipients who received >= 1 dose of IV-administered cidofovir for any dsDNA viral infection from 2006 to 2019. The objectives were to describe the rate of and risk factors for nephrotoxicity and virological response by the end of treatment (EOT). Results: We included 165 patients from nine centres. Cidofovir was administered at 5 mg/kg/week (N=115; 69.7%), 1 mg/kg/week (18; 10.9%), 3mg/kg/week (12; 7.3%) or 1 mg/kg three times/week (11; 6.7%). Cidofovir was administered for adenovirus, cytomegalovirus (CMV) and BK virus infection in 75 (45.5%), 64 (38.8%) and 51 (30.9%) patients, respectively. Among 158 patients with renal function data at baseline and EOT, 40 (25.3%) developed nephrotoxicity. In multivariable analyses, age (OR 1.04; P=0.05), weight (OR 1.05; P=0.01), CMV infection (OR 3.6; P=0.02), liposomal amphotericin B (OR 8.06; P=0.05) and IV voriconazole/posaconazole (OR 13.0; P=0.003) were predictors of nephrotoxicity. Creatinine concentration was significantly higher at EOT (1.160.95 mg/dL) compared with baseline (0.91 +/- 0.39 mg/dL; P<0.001), but improved by 2weeks (0.91 +/- 0.84 mg/dL; P=0.007) and 4 weeks (0.96 +/- 0.89 mg/dL; P=0.03) post-EOT. Median viral load significantly declined for patients with adenovirus DNAaemia by EOT (P<0.0001) and for patients with CMV DNAaemia by EOT+4 weeks (P=0.003), but not for patients with BK virus DNAaemia. Conclusions: One in four HCT recipients treated with IV cidofovir developed largely reversible nephrotoxicity. Careful selection of patients and close follow-up of renal function may minimize toxicity.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stern, Anat UNSPECIFIED orcid.org/0000-0002-8659-8108 UNSPECIFIED Alonso, Carolyn D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Garcia-Vidal, Carolina UNSPECIFIED UNSPECIFIED UNSPECIFIED Cardozo, Celia UNSPECIFIED UNSPECIFIED UNSPECIFIED Slavin, Monica UNSPECIFIED orcid.org/0000-0002-8443-314X UNSPECIFIED Yong, Michelle K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ho, Su Ann UNSPECIFIED UNSPECIFIED UNSPECIFIED Steinke, Seema Mehta UNSPECIFIED UNSPECIFIED UNSPECIFIED Avery, Robin K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koehler, Philipp UNSPECIFIED orcid.org/0000-0002-7386-7495 UNSPECIFIED Scheid, Christof UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maertens, Johan UNSPECIFIED UNSPECIFIED UNSPECIFIED Aad, Yasmine Abi UNSPECIFIED UNSPECIFIED UNSPECIFIED Epstein, David J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Papanicolaou, Genovefa A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Neofytos, Dionysios UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-601392
DOI:	10.1093/jac/dkab259
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	76
Number:	11
Page Range:	S. 3020 - 3029
Date:	2021
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEMORRHAGIC CYSTITIS; CYTOMEGALOVIRUS-INFECTION; EUROPEAN-GROUP; ADENOVIRUS; DISEASE; GANCICLOVIR; GUIDELINES; DIAGNOSIS; THERAPY; BLOOD Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60139