Chen I-Ming, Chang Hsiao-Huang, Hsu Chiao-Po, Lai Shiau-Ting, Hsieh Yuan-Chen, Shih Chun-Che
Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, 201 Sec.2 Shih-Pai Road, Taipei 112, Taiwan.
Circ J. 2007 Jun;71(6):968-72. doi: 10.1253/circj.71.968.
Valganciclovir (VGC) has recently been proved efficacious for the prophylaxis and treatment of cytomegalovirus (CMV) infection in transplant recipients. Leucopenia is a troublesome complication of VGC but the possible risk factors are unknown.
Once a cardiac recipient's quantitative real-time CMV-polymerase chain reaction result showed positive, VGC was administered for 3 months. The 61 cardiac recipients enrolled in this study were divided into 2 groups: non-leucopenia group (n=29) and leucopenia group (n=32). The white blood cell (WBC) counts in the leucopenia group dropped approximately 55.6% in the first month after VGC therapy (pre-VGC WBC count: 5,544 cells/mm(3) vs post-VGC WBC count: 2,460 cells/mm(3), p<0.0001). The most significant difference between the 2 groups was body mass index (BMI, 23.04 vs 25.84, p=0.008), which was the impact factor of VGC-induced leucopenia.
Severe leucopenia may develop after VGC therapy in Chinese cardiac recipients, especially those with lower BMI.
缬更昔洛韦（VGC）最近已被证明对预防和治疗移植受者的巨细胞病毒（CMV）感染有效。白细胞减少是VGC的一个棘手并发症，但可能的危险因素尚不清楚。
一旦心脏移植受者的定量实时CMV聚合酶链反应结果呈阳性，即给予VGC治疗3个月。本研究纳入的61名心脏移植受者分为两组：非白细胞减少组（n = 29）和白细胞减少组（n = 32）。白细胞减少组的白细胞（WBC）计数在VGC治疗后的第一个月下降了约55.6%（VGC治疗前WBC计数：5544个细胞/mm³ vs VGC治疗后WBC计数：2460个细胞/mm³，p<0.0001）。两组之间最显著的差异是体重指数（BMI，23.04对25.84，p = 0.008），这是VGC诱导白细胞减少的影响因素。
中国心脏移植受者在VGC治疗后可能会出现严重的白细胞减少，尤其是BMI较低的受者。
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