Foscarnet therapy for ganciclovir-resistant cytomegalovirus retinitis after stem cell transplantation: effective monitoring of CMV infection by quantitative analysis of CMV mRNA

We report three pediatric patients with ganciclovir-resistant cytomegalovir us (CMV) retinitis who were successfully treated with foscarnet, The patien ts were recipients of hematopoietic stem cell transplantation (SCT) from HL A-mismatched donors. Because these patients had developed or experienced pr ogressive CMV retinitis during ganciclovir therapy, they received foscarnet therapy at 60 mg/kg every 8 h, Their retinitis resolved promptly after ini tiating foscarnet therapy, suggesting foscarnet's effectiveness in treating ganciclovir-resistant CMV infection. The amount of CMV mRNA was quantitati vely measured using an NASBA technique, which amplified the beta2.7 transcr ipts specific for CMV replication. This technique was useful for monitoring disease activity in a more rapid and sensitive manner than the PCR assay f or CMV DNA.