Valganciclovir to Prevent Cytomegalovirus Infection in Patients Following Donor Stem Cell Transplantation

This study has been completed.
Information provided by:
Fred Hutchinson Cancer Research Center Identifier:
First received: May 6, 2001
Last updated: May 14, 2010
Last verified: May 2010

RATIONALE: Antivirals such as valganciclovir act against viruses and may be effective in preventing cytomegalovirus. It is not yet known if valganciclovir is effective in preventing cytomegalovirus.

PURPOSE: This randomized phase III trial is studying valganciclovir to see how well it works in preventing cytomegalovirus in patients who have undergone donor stem cell transplantation.

Condition Intervention Phase
Drug: ganciclovir
Drug: valganciclovir
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Masking: Double-Blind
Primary Purpose: Supportive Care
Official Title: A Phase III Multicenter Study Of Valganciclovir For The Prevention Of Late Cytomegalovirus Infection After Allogeneic Hematopoietic Stem Cell Transplantation

Resource links provided by NLM:

Further study details as provided by Fred Hutchinson Cancer Research Center:

Primary Outcome Measures:
  • Late cytomegalovirus infection by plasma PCR positivity

Estimated Enrollment: 184
Study Start Date: January 2001
Study Completion Date: September 2007
Detailed Description:



  • Compare cytomegalovirus (CMV) disease and non-CMV invasive infection-free survival in patients undergoing allogeneic hematopoietic stem cell transplantation treated with valganciclovir vs placebo.
  • Compare the incidence of CMV disease in patients treated with these drugs.
  • Compare the incidence of other severe invasive bacterial and fungal infections and overall survival in patients treated with these drugs.


  • Compare the incidence of CMV infection or disease at baseline and at days 270 and 640 after allogeneic hematopoietic stem cell transplantation in patients treated with these drugs.
  • Compare the incidence of herpes simplex virus and varicella-zoster virus infections at baseline and day 270 in patients treated with these drugs.
  • Determine the safety of valganciclovir in these patients.
  • Compare the quality of life of patients treated with these drugs.
  • Compare CMV-specific immune reconstitution in patients treated with these drugs.

OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to participating center, prior neutropenia (yes vs no), and presence of refractory graft-versus-host disease requiring secondary therapy (yes vs no). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral valganciclovir daily.
  • Arm II: Patients receive oral placebo daily. Treatment begins around day 80-120 post-transplantation and continues until day 270 post-transplantation in the absence of active infection or unacceptable toxicity. Patients developing active cytomegalovirus (CMV) infection receive induction doses of ganciclovir IV or open-label oral valganciclovir for 1 week followed by open-label oral valganciclovir maintenance dosing until CMV can no longer be detected.

Quality of life is assessed at baseline and days 180 and 270 post-transplantation.

Patients are followed at days 400, 520, and 640 post-transplantation.

PROJECTED ACCRUAL: A total of 184 patients (92 per treatment arm) will be accrued for this study.


Ages Eligible for Study:   16 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No


  • Have undergone allogeneic peripheral blood stem cell, cord blood, or marrow transplantation (related or unrelated, T-cell depleted or non-T-cell depleted, CD34-selected or non-selected, or myeloablative or non-myeloablative) within the past 80-120 days
  • Positive pre-transplantation cytomegalovirus (CMV) serology of recipient and/or donor

    • Seropositive recipients with one of the following:

      • CMV infection before day 80, as determined by:

        • pp65 antigenemia
        • CMV DNA in plasma
        • Peripheral blood leukocytes (PBL) or whole blood at any level detected by polymerase chain reaction or hybrid capture
        • CMV pp67 mRNA
        • CMV viremia by blood culture
        • Surveillance bronchoalveolar lavage (culture or cytology)
      • CMV disease more than 6 weeks prior to enrollment
      • Presence of graft-versus-host disease (GVHD) at enrollment

        • Acute GVHD that requires treatment with systemic corticosteroids of doses greater than 0.5 mg/kg OR
        • Chronic clinically extensive GVHD requiring treatment with corticosteroids
      • Continuous prophylaxis with ganciclovir, foscarnet, or cidofovir between engraftment and day 80 OR
    • Seronegative recipient with seropositive donor who has CMV infection before day 80
  • No rising or uncontrolled CMV load (pp65 antigenemia levels no greater than 1/slide or no greater than 100 copies of CMV DNA per mL of plasma or per million PBL allowed)
  • No CMV disease within 6 weeks prior to randomization
  • No leukemic relapse

    • Cytogenetic or molecular relapse allowed



  • 16 and over

Performance status:

  • Not specified

Life expectancy:

  • At least 2 weeks


  • Absolute neutrophil count at least 1,000/mm^3 for at least 1 week prior to enrollment


  • Not specified


  • Creatinine no greater than 2.5 mg/mL


  • No hypersensitivity to ganciclovir or valganciclovir
  • No uncontrolled diarrhea or severe gastrointestinal disease that would preclude oral medication
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 90 days after study participation
  • HIV negative
  • Proficient in English


Biologic therapy:

  • See Disease Characteristics


  • Not specified

Endocrine therapy:

  • See Disease Characteristics


  • Not specified


  • Not specified


  • Prior ganciclovir, foscarnet, cidofovir, high-dose acyclovir, or valacyclovir as prophylaxis or preemptive therapy allowed
  • No concurrent prophylactic foscarnet, cidofovir, or ganciclovir (IV or oral)
  • No concurrent prophylactic high-dose acyclovir (more than 800 mg twice daily), valacyclovir (more than 500 mg twice daily), cidofovir (more than 0.5 mg/kg per week), or famciclovir (more than 500 mg/day) except for limited treatment courses at higher doses for varicella-zoster virus infections

    • Concurrent low-dose (≤ 0.5 mg/kg per week) cidofovir allowed for limited treatment courses
  Contacts and Locations
Please refer to this study by its identifier: NCT00016068

United States, California
City of Hope Comprehensive Cancer Center
Duarte, California, United States, 91010-3000
United States, Florida
University of Florida Shands Cancer Center
Gainesville, Florida, United States, 32610-0232
United States, Michigan
Barbara Ann Karmanos Cancer Institute
Detroit, Michigan, United States, 48201-1379
United States, Minnesota
Mayo Clinic Cancer Center
Rochester, Minnesota, United States, 55905
United States, New York
Memorial Sloan-Kettering Cancer Center
New York, New York, United States, 10021
United States, Texas
M.D. Anderson Cancer Center at University of Texas
Houston, Texas, United States, 77030-4009
United States, Washington
Fred Hutchinson Cancer Research Center
Seattle, Washington, United States, 98109-1024
Sponsors and Collaborators
Fred Hutchinson Cancer Research Center
Study Chair: Michael Boeckh, MD Fred Hutchinson Cancer Research Center
  More Information

Additional Information:
No publications provided Identifier: NCT00016068     History of Changes
Other Study ID Numbers: 1577.00, FHCRC-1577.00, MSKCC-01127, NCI-H01-0072
Study First Received: May 6, 2001
Last Updated: May 14, 2010
Health Authority: United States: Federal Government
United States: Food and Drug Administration

Keywords provided by Fred Hutchinson Cancer Research Center:

Additional relevant MeSH terms:
Cytomegalovirus Infections
Herpesviridae Infections
DNA Virus Infections
Virus Diseases
Antiviral Agents
Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions processed this record on April 17, 2014