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Antiviral Res. 2016 Nov;135:91-96. doi: 10.1016/j.antiviral.2016.08.027. Epub 2016 Sep 1.

Adjuvant and salvage therapy with leflunomide for recalcitrant cytomegalovirus infections in hematopoietic cell transplantation recipients: A case series.

Author information

1
Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Internal Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA.
2
Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
3
Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
4
Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
5
Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
6
Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: rfchemaly@mdanderson.org.

Abstract

Cytomegalovirus (CMV) reactivation is a clinically significant complication in hematopoietic stem cell transplant (HCT) recipients. Alternative therapy for multidrug-resistant CMV is limited and often fails. Leflunomide has been used to treat resistant CMV infections, however, data on efficacy, safety, and guidance for therapeutic drug level monitoring are lacking. In this report, we describe 3 HCT recipients with multi-drug resistant CMV infections who received leflunomide as adjuvant and salvage therapy. The therapeutic effect of leflunomide as an anti-CMV agent based on virologic responses and therapeutic drug monitoring were evaluated.

KEYWORDS:

Cytomegalovirus; Drug level; Leflunomide; Resistance; Stem cell transplant

PMID:
27594527
DOI:
10.1016/j.antiviral.2016.08.027
[Indexed for MEDLINE]

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