Article Text

  1. D. Vu1,
  2. A. Peck1,2,
  3. G. Nichols1,2,
  4. C. Varley2,
  5. J. Englund1,2,
  6. L. Corey1,2,
  7. M. Boeckh1,2
  1. 1University of Washington, Seattle, WA
  2. 2Fred Hutchinson Cancer Research Center, Seattle, WA.


Background Oseltamivir is safe and effective in immunocompetent persons, and prophylactic use is recommended in the setting of an influenza outbreak; however, no data exist for use as prophylaxis among hematopoietic stem cell transplantation (HCT) candidates and recipients.

Methods In January 2002, an influenza outbreak was identified when four cases occurred within 1 week at an outpatient residential facility for HCT patients. Oseltamivir prophylaxis (75 mg QD) was initiated 1 week after and given to 44 patients living in the same housing facility (25 post-HCT recipients, 19 pre-HCT candidates). Retrospectively, these 44 patients were matched 1:1 with controls transplanted between 1994 and 2003 who did not receive prophylaxis according to donor type, conditioning regimen, CMV serostatus, and recipient age ± 5 years. Frequency of clinical and laboratory adverse events (AEs) was determined by chart review and graded using the NCI Common Toxicity Criteria (CTC), grades ranging from 0 (no AE) to 5 (death).

Results Forty-four patients received oseltamivir for a median of 24 days (range 15-88). Eleven pre-HCT candidates received HCT while taking prophylaxis and did not develop influenza. One of 44 patients developed influenza infection 28 days after oseltamivir was initiated; this patient had been noncompliant with dosing. No CTC grade 5 AEs occurred in either the prophylaxis or control group. The proportion of clinical AEs meeting CTC grades 2 to 4 or 3 to 4 was not significantly different between patients receiving oseltamivir and controls. There was also no difference in the proportion of laboratory abnormalities meeting CTC grades 2 to 4 between groups.

Conclusion Oseltamivir prophylaxis appeared to be safe and well tolerated in managing an influenza outbreak in an HCT outpatient residential setting.

Statistics from

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.