TREATMENT OF GANCYCLOVIR RESISTANT CYTOMEGALOVIRUS WITH FOSCARNET - AREPORT OF 2 CASES OCCURRING AFTER BONE-MARROW TRANSPLANTATION

Cytomegalovirus (CMV) infection is common in patients who undergo allo geneic bone marrow transplantation. Gancyclovir is useful in treating CMV infections. Resistance to gancyclovir is rare and has, thus far, n ot been reported in the setting of BMT. Two patients with CMV infectio ns unresponsive to gancyclovir were successfully treated with foscarne t. 1015% of CMV infections are resistant initially or develop resistan ce to gancyclovir. Both patients had an adequate trial of gancyclovir and resistance developed over time. While we did not document resistan ce in the laboratory there was dramatic clinical improvement with fosc arnet.