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JAC Advance Access published online on March 21, 2006
Journal of Antimicrobial Chemotherapy, 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
Received October 3, 2005
Revised January 25, 2006
Accepted February 24, 2006

Brief report

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

Yuki Asano-Mori 1, Yoshinobu Kanda 2 *, Kumi Oshima 2, Takuro Watanabe 1, Eriko Shoda 1, Toru Motokura 1, Mineo Kurokawa 2, and Shigeru Chiba 2

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

* To whom correspondence should be addressed.
Yoshinobu Kanda, E-mail: ycanda-tky{at}umin.ac.jp


  Abstract

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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