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Safety and tolerability of cidofovir in high-risk pediatric patients

V A Bhadri1, L Lee-Horn, P J Shaw

  • 1Oncology, Children's Hospital at Westmead, New South Wales, Australia.

Transplant Infectious Disease : an Official Journal of the Transplantation Society
|April 28, 2009
PubMed

Insights

Cidofovir is a primary treatment for adenovirus infections post-hematopoietic stem cell transplant. This study shows cidofovir is safe and well-tolerated in pediatric patients, with acceptable kidney safety despite other medications.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Pediatric Oncology

Background:

  • Adenovirus (ADV) infection poses a significant threat after hematopoietic stem cell transplantation (HSCT), leading to considerable illness and death.
  • Cidofovir is the main treatment for ADV infections, but potential kidney toxicity restricts its use.

Purpose of the Study:

  • To evaluate the safety and tolerability of cidofovir in pediatric patients undergoing HSCT.
  • To assess the incidence of nephrotoxicity associated with cidofovir treatment in this high-risk population.

Main Methods:

  • Retrospective analysis of 234 cidofovir infusions administered to 23 pediatric patients at a single institution.
  • Monitoring for adverse events, including nephrotoxicity, during cidofovir therapy.
  • Evaluation of concomitant use of other nephrotoxic agents.

Main Results:

  • Cidofovir was administered safely across 234 infusions in 23 pediatric patients.
  • Adverse events were infrequent, with only three patients experiencing issues, two linked to the hydration protocol.
  • Evidence suggests acceptable kidney safety, even with concurrent use of other nephrotoxic medications.

Conclusions:

  • Cidofovir demonstrates a favorable safety and tolerability profile in pediatric patients at high risk post-HSCT.
  • The drug can be administered with acceptable kidney safety, mitigating concerns about nephrotoxicity in this vulnerable group.

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