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JAC Advance Access originally published online on March 21, 2006
Journal of Antimicrobial Chemotherapy 2006 57(5):1004-1007; doi:10.1093/jac/dkl089
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Pharmacokinetics of ganciclovir in haematopoietic stem cell transplantation recipients with or without renal impairment

Yuki Asano-Mori1, Yoshinobu Kanda1,2,*, Kumi Oshima1,2, Takuro Watanabe1, Eriko Shoda1, Toru Motokura1, Mineo Kurokawa1,2 and Shigeru Chiba1,2

1 Department of Hematology & Oncology, University of Tokyo Graduate School of Medicine and Hospital, Tokyo, Japan; 2 Department of Cell Therapy & Transplantation Medicine, University of Tokyo Hospital, Tokyo, Japan

Received 3 October 2005; returned 22 November 2005; revised 25 January 2006; accepted 24 February 2006

* Corresponding author. Tel: +81-3-3815-5411 ext. 35602; Fax: +81-3-5804-6261; E-mail: ycanda-tky{at}umin.ac.jp

Objectives: We investigated the pharmacokinetics of ganciclovir in 12 haematopoietic stem cell transplantation (HSCT) recipients to evaluate the validity of a 50% reduction in the ganciclovir dosage for mild renal impairment.

Patients and methods: Ganciclovir at 5 mg/kg/day was pre-emptively infused in patients with estimated CLCR ≥ 70 mL/min (Group A), whereas the dose was reduced to 2.5 mg/kg/day in patients with CLCR between 50 and 70 mL/min (Group B).

Results: The peak concentration was significantly higher in Group A (P < 0.01). However, the decrease in the plasma ganciclovir concentration was slower in Group B (P = 0.09), and the AUC of all patients in both groups was distributed within a narrow range (25.6 ± 4.77 µg·h/mL), when two patients with exceptionally high AUC values were excluded.

Conclusions: A 50% reduction in ganciclovir appeared to be appropriate for patients with mild renal impairment. Measuring the ganciclovir concentration at 4 h after starting infusion may be adequate for evaluating AUC.

Keywords: cytomegalovirus , CMV , antigenaemia , antiviral therapy


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