What do systematic reviews say?

Ganciclovir vs aciclovir

Ganciclovir may leads to higher leucopenia compared with aciclovir (low certainty).

• Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients 2024 · Cochrane Headline outcomes only
  RR 3.28 [1.48, 7.25]
  6 studies · 955 participants
  Low

Valaciclovir vs ganciclovir or valganciclovir

Valaciclovir showed no clear difference in leucopenia compared with ganciclovir or valganciclovir (moderate certainty).

• Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients 2024 · Cochrane Headline outcomes only
  RR 0.74 [0.45, 1.24]
  2 studies · 188 participants
  Moderate

Antiviral prophylaxis vs placebo or no treatment

Antiviral prophylaxis showed no clear difference in leucopenia compared with placebo or no treatment (moderate certainty).

• Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients 2024 · Cochrane Headline outcomes only
  RR 1.03 [0.67, 1.59]
  4 studies · 1125 participants
  Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: secondary outcomes

Target of rapamycin inhibitors (TOR‐I) may leads to lower leucopenia compared with antimetabolites: secondary outcomes (low certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.43 [0.33, 0.56]
  15 studies · 8396 participants
  Low

Intervention not reported

The intervention showed no clear difference in leucopenia (moderate certainty).

• Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
  RR 0.99 [0.7, 1.4]
  5 studies · 1012 participants
  Moderate

Azathioprine vs mycophenolate

Azathioprine (AZA) may leads to higher leucopenia compared with mycophenolate mofetil (MMF) (low certainty).

• Immunosuppressive treatment for proliferative lupus nephritis 2018 · Cochrane Headline outcomes only
  RR 5.61 [1.68, 18.72]
  3 studies · 412 participants
  Low

Pre‐emptive medication vs prophylaxis

• Pre‐emptive treatment for cytomegalovirus viraemia to prevent cytomegalovirus disease in solid organ transplant… 2013 · Cochrane Headline outcomes only
  no estimate extracted
  6 studies · 729 participants
  Moderate

Pre‐emptive medication for cytomegalovirus (CMV) viraemia vs placebo/no treatment

• Pre‐emptive treatment for cytomegalovirus viraemia to prevent cytomegalovirus disease in solid organ transplant… 2013 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 114 participants
  Low

Alkylating agents vs steroids, placebo or both

Alkylating agents led to higher CPA: leucopenia compared with steroids, placebo or both; GRADE not reported.

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 10.63 [1.45, 78.05]
  Studies not reported
  GRADE not reported

Alkylating agents vs steroids, placebo or both

Alkylating agents showed no clear difference in chlorambucil: leucopenia compared with steroids, placebo or both; GRADE not reported.

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 2.5 [0.11, 54.87]
  Studies not reported
  GRADE not reported

Intravenous vs oral cyclophosphamide

Intravenous showed no clear difference in adverse events: leucopenia compared with oral cyclophosphamide (low certainty).

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 0.37 [0.09, 1.51]
  2 studies · 83 participants
  Low

Levamisole vs steroids or placebo or both, or no treatment

Levamisole showed no clear difference in adverse effects: leucopenia compared with steroids or placebo or both, or no treatment (low certainty).

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 4.18 [0.72, 24.21]
  3 studies · 214 participants
  Low

Levamisole vs cyclophosphamide

Levamisole showed no clear difference in adverse effects: leucopenia compared with cyclophosphamide (low certainty).

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 0.25 [0.04, 1.48]
  2 studies · 97 participants
  Low

Alkylating agents vs cyclosporin

It is very uncertain whether alkylating agents changes adverse effects: leucopenia compared with cyclosporin (very low certainty).

• Non‐corticosteroid immunosuppressive medications for steroid‐sensitive nephrotic syndrome in children 2020 · Cochrane Headline outcomes only
  RR 29.84 [1.84, 483.93]
  1 study · 66 participants
  Very low