Acyclovir influence on graft versus host disease.

Abstract

Allogeneic bone marrow transplantation has been used for over two decades as a therapy to treat patients with malignant disease [Thomas et al., 1977; Geller et al., 1989; Clift et al., 1987; Gratwohl et al., 1990; Goldman et al., 1986; Thomas et al., 1986]. High doses of chemotherapy are administered either alone or in combination with total body irradiation in an attempt to eradicate malignant cells. The treatment may be lethal to normal bone marrow function, but this toxicity is overcome by providing bone marrow from an external source. In allogeneic bone marrow transplantation, bone marrow is obtained from an HLA identical family member or unrelated donor. In recent years the use of less well-matched donors has increased, thus expanding the use of this strategy to a larger patient population. The success rate of allogeneic bone marrow transplantation has been greatest in the treatment of haematopoietic malignancies. Patients with acute or chronic leukaemia have a 30-80 percent likelihood of being free of disease at 5 years following transplantation. The success rate depends on the stage of disease at the time of transplantation. Certain nonmalignant diseases have also been treated successfully with allogeneic bone marrow transplantation. These include severe aplastic anaemia, inborn errors of metabolism, and other genetically determined diseases [Storb et al., 1986a, 1991; Lucarelli et al., 1990; Kirkpatrick et al., 1991]. With the availability of effective antiviral therapy, treatment and prophylaxis are available for HSV, CMV, and VZV. Acyclovir has been shown to be effective in treating established infections with HSV and VZV, and in the prophylaxis against HSV, severe CMV infections, and VZV.(ABSTRACT TRUNCATED AT 250 WORDS)