Combination therapy for multidrug-resistant cytomegalovirus disease

C Stuehler; G Stüssi; J Halter; J Nowakowska; A Schibli; M Battegay; J Dirks; J Passweg; D Heim; A Rovo; C Kalberer; C Bucher; M Weisser; A Dumoulin; H H Hirsch; N Khanna

doi:10.1111/tid.12435

Combination therapy for multidrug-resistant cytomegalovirus disease

Transpl Infect Dis. 2015 Oct;17(5):751-5. doi: 10.1111/tid.12435. Epub 2015 Oct 3.

Authors

C Stuehler¹, G Stüssi², J Halter³, J Nowakowska¹, A Schibli⁴, M Battegay⁴, J Dirks³, J Passweg³, D Heim³, A Rovo³, C Kalberer³, C Bucher³, M Weisser⁴, A Dumoulin⁵, H H Hirsch^{4

5}, N Khanna^{1

4}

Affiliations

¹ Infection Biology Laboratory, Department of Biomedicine, University and University Hospital of Basel, Basel, Switzerland.
² Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
³ Division of Hematology, Department of Biomedicine and Clinical Research, University Hospital of Basel, Basel, Switzerland.
⁴ Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland.
⁵ Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland.

PMID: 26432076
DOI: 10.1111/tid.12435

Abstract

Multidrug-resistant (MDR) cytomegalovirus (CMV) emerged after transient responses to ganciclovir, foscarnet, and cidofovir in a CMV-seropositive recipient who underwent allogeneic hematopoietic stem cell transplantation from a CMV-seronegative donor. Experimental treatments using leflunomide and artesunate failed. Re-transplantation from a CMV-seropositive donor supported by adoptive transfer of pp65-specific T cells and maribavir was followed by lasting suppression. This case illustrates that successful MDR CMV therapy may require individualized multidisciplinary approaches.

Keywords: adoptive T-cell transfer; allogeneic hematopoietic stem cell transplantation; cytomegalovirus; maribavir; multidrug resistance.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adoptive Transfer
Antiviral Agents / therapeutic use
Combined Modality Therapy
Cytomegalovirus Infections / immunology
Cytomegalovirus Infections / therapy*
Drug Resistance, Multiple, Viral*
Drug Therapy, Combination
Hematopoietic Stem Cell Transplantation*
Humans
Immunocompromised Host*
Male
Middle Aged

Substances

Antiviral Agents