Guidelines for the management of cytomegalovirus infection in patients with haematological malignancies and after stem cell transplantation from the 2017 European Conference on Infections in Leukaemia (ECIL 7)

Lancet Infect Dis. 2019 Aug;19(8):e260-e272. doi: 10.1016/S1473-3099(19)30107-0. Epub 2019 May 29.

Abstract

Cytomegalovirus is one of the most important infections to occur after allogeneic haematopoietic stem cell transplantation (HSCT), and an increasing number of reports indicate that cytomegalovirus is also a potentially important pathogen in patients treated with recently introduced drugs for hematological malignancies. Expert recommendations have been produced by the 2017 European Conference on Infections in Leukaemia (ECIL 7) after a review of the literature on the diagnosis and management of cytomegalovirus in patients after HSCT and in patients receiving other types of therapy for haematological malignancies. These recommendations cover diagnosis, preventive strategies such as prophylaxis and pre-emptive therapy, and management of cytomegalovirus disease. Antiviral drugs including maribavir and letermovir are in development and prospective clinical trials have recently been completed. However, management of patients with resistant or refractory cytomegalovirus infection or cytomegalovirus disease is a challenge. In this Review we summarise the reviewed literature and the recommendations of the ECIL 7 for management of cytomegalovirus in patients with haematological malignancies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Benzimidazoles / therapeutic use
  • Cytomegalovirus / immunology
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / etiology
  • Cytomegalovirus Infections / prevention & control
  • Ganciclovir / therapeutic use
  • Hematologic Neoplasms / drug therapy*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Leukemia / complications*
  • Leukemia / drug therapy
  • Practice Guidelines as Topic*
  • Ribonucleosides / therapeutic use

Substances

  • Antiviral Agents
  • Benzimidazoles
  • Ribonucleosides
  • Ganciclovir
  • maribavir