Ganciclovir inhibits lymphocyte proliferation by impairing DNA synthesis

Biol Blood Marrow Transplant. 2007 Jul;13(7):765-70. doi: 10.1016/j.bbmt.2007.03.009. Epub 2007 May 7.


Cytomegalovirus (CMV) disease-related mortality in allogeneic hematopoietic stem cell transplant (HSCT) recipients has dramatically declined because of ganciclovir prophylaxis and preemptive therapeutic strategies. However, ganciclovir has not improved overall survival in randomized studies despite effectively preventing overt CMV disease. Moreover, recurrent posttransplant CMV antigenemia, associated with prolonged ganciclovir exposure, is a predictor of increased relapse of malignancy. We examined the hypothesis that ganciclovir itself may have a negative impact on immune reconstitution by testing the effect of ganciclovir on normal human lymphocytes in vitro. T-lymphocyte activation and proliferation, as measured by PHA-induced (3)H-thymidine uptake, was greatly reduced at therapeutic concentrations of ganciclovir (10 microg/mL) but not for foscarnet (300 microM/L). Moreover, ganciclovir impaired bromodeoxyuridine incorporation in proliferating lymphocytes, but did not impair lymphocyte survival or induce lymphocyte apoptosis. Collectively, these results show that ganciclovir suppresses T-lymphocyte proliferation in vitro by inhibiting DNA synthesis; with implications for T-lymphocyte function following allogeneic BMT.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Antiviral Agents / adverse effects*
  • Antiviral Agents / pharmacology*
  • Antiviral Agents / therapeutic use
  • Apoptosis / drug effects
  • Apoptosis / immunology
  • Cell Proliferation / drug effects*
  • Cell Survival / drug effects
  • Cell Survival / immunology
  • Cells, Cultured
  • Cytomegalovirus / immunology
  • Cytomegalovirus / metabolism
  • Cytomegalovirus Infections / immunology
  • Cytomegalovirus Infections / metabolism
  • Cytomegalovirus Infections / mortality
  • Cytomegalovirus Infections / prevention & control
  • DNA / biosynthesis*
  • Ganciclovir / adverse effects*
  • Ganciclovir / pharmacology
  • Ganciclovir / therapeutic use
  • Hematopoietic Stem Cell Transplantation / mortality
  • Humans
  • Lymphocyte Activation / drug effects*
  • Lymphocyte Activation / immunology
  • Recovery of Function / drug effects
  • Recovery of Function / immunology
  • T-Lymphocytes / immunology
  • T-Lymphocytes / metabolism*
  • Transplantation, Homologous


  • Antiviral Agents
  • DNA
  • Ganciclovir