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Published on: September 11, 2012
Cytomegalovirus colitis following azacitidine therapy
Rajal Khan1, Pam Rudkin, Kuljit Grewal
1Department of Internal Medicine;
Summary
Cytomegalovirus (CMV) colitis is a newly identified risk following azacitidine treatment for myelodysplastic syndrome. Prompt ganciclovir treatment effectively managed this case, suggesting a need for revised patient monitoring protocols.
Area of Science:
- Oncology
- Virology
- Gastroenterology
Background:
- Azacitidine is a hypomethylating agent used in myelodysplastic syndromes (MDS).
- Cytomegalovirus (CMV) infections can occur in immunocompromised patients.
- Current guidelines do not mandate CMV screening or prophylaxis for patients on azacitidine.
Observation:
- A 66-year-old female patient with MDS developed severe gastrointestinal symptoms.
- Endoscopic evaluation revealed characteristic CMV colitis.
- The patient had recently received azacitidine therapy.
Findings:
- This case represents the first documented instance of CMV colitis directly linked to azacitidine treatment.
- The patient's CMV colitis responded successfully to antiviral therapy with ganciclovir.
- The findings highlight a potential complication of azacitidine therapy in MDS patients.
Implications:
- Current protocols for azacitidine therapy may require revision to include CMV monitoring.
- Prophylactic measures or preemptive screening for CMV in MDS patients on azacitidine should be considered.
- This case underscores the importance of recognizing opportunistic infections in patients undergoing intensive cancer treatment.
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