Abstract
Fludarabine has been associated with an increased risk of opportunistic infections, possibly related to the induction of profound CD4+ lymphopenia. We observed two cases of cytomegalovirus pneumonia (CMV-IP) in a total of nine patients over a 5-year period who had previously received fludarabine and who proceeded to autografting. Both patients also received steroids post-transplant. CMV-IP was observed in one of 104 other autograft recipients over this time who had not received prior fludarabine. This observation suggests that the combination of fludarabine pre-transplant and steroids post-transplant may increase the risk of invasive CMV disease in autograft recipients.
MeSH terms
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Adult
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Anti-Inflammatory Agents / adverse effects*
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Cyclophosphamide / therapeutic use
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Cytomegalovirus Infections / etiology*
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Doxorubicin / therapeutic use
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Drug Synergism
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Female
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Humans
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Immunosuppressive Agents / adverse effects*
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Lymphoma, Non-Hodgkin / therapy
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Male
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Pneumonia, Viral / etiology*
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Prednisolone / adverse effects*
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Prednisone / therapeutic use
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Transplantation Conditioning
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Transplantation, Autologous
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Vidarabine / adverse effects
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Vidarabine / analogs & derivatives*
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Vincristine / therapeutic use
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Viral Load
Substances
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Anti-Inflammatory Agents
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Immunosuppressive Agents
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Prednisolone
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Vidarabine
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fludarabine
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Prednisone