{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T13:41:42Z","timestamp":1787578902725,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:00:00Z","timestamp":1704412800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Valganciclovir (VGCV) prophylaxis is associated with an increased risk of hematologic side effects. We analyzed the impact of VGCV prophylaxis on leukopenia and neutropenia rates and explored risk factors for its occurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study of adult cytomegalovirus (CMV)\u2010seronegative solid organ transplantation (SOT) recipients of either CMV\u2010seropositive (CMV D+\/R\u2010) or CMV\u2010seronegative (CMV D\u2010\/R\u2010) donors between July 2005 and March 2019. CMV D+\/R\u2010 SOT recipients received 3\u201312 months of VGCV prophylaxis whereas CMV D\u2010\/R\u2010 SOT recipients received no VGCV prophylaxis. Competing risk regression was used to calculate risk factors for significant neutropenia (neutrophil count &lt; 1000\/\u03bcL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 430 CMV\u2010seronegative SOT recipients (median age of 52.1 years, 76.5% males) were included, of which 203 (47.2%) were CMV D+\/R\u2010 and 227 (52.8%) CMV D\u2010\/R\u2010. The unadjusted incidence rate ratio of significant neutropenia attributable to VGCV exposure in the first year post\u2010transplant was 13.50 (95% confidence interval 7.36\u201327.11). Acute rejection occurred more frequently in neutropenic patients at 32.5% compared to 19.1% in those without neutropenia (<jats:italic>p<\/jats:italic>= .033). On multivariate analysis, VGCV prophylaxis for 1\u201390 days and 91\u2013180 days versus no VGCV were the strongest risk factors for significant neutropenia with a sub\u2010distribution hazard ratio of 39.6 (95% CI, 8.57\u2013182.6) and 13.2 (95% CI, 5.46\u201332.0), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>VGCV prophylaxis is limited by high rates of neutropenia. Future prospective studies are needed to assess alternative CMV prophylactic strategies in SOT recipients.<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14227-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14227","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T10:52:57Z","timestamp":1704451977000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Incidence of valganciclovir\u2010related leukopenia and neutropenia in solid organ transplant recipients at high risk of cytomegalovirus disease"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1725-1407","authenticated-orcid":false,"given":"Sara","family":"Belga","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases University of British Columbia Vancouver Canada"},{"name":"Immunity and Infection Research Centre Vancouver Coastal Health Research Institute Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hospital Santa Caterina Girona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3785-1098","authenticated-orcid":false,"given":"Dima","family":"Kabbani","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases University of Alberta Edmonton 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