New advances in the management of cytomegalovirus in allogeneic haemopoietic stem cell transplantation

Michelle K Yong; David Gottlieb; Julian Lindsay; Jen Kok; William Rawlinson; Monica Slavin; David Ritchie; Ashish Bajel; Andrew Grigg

doi:10.1111/imj.14462

New advances in the management of cytomegalovirus in allogeneic haemopoietic stem cell transplantation

Intern Med J. 2020 Mar;50(3):277-284. doi: 10.1111/imj.14462.

Authors

Michelle K Yong^{1

2

3}, David Gottlieb^{4

5

6}, Julian Lindsay^{3

7}, Jen Kok⁸, William Rawlinson⁹, Monica Slavin^{1

2

3}, David Ritchie^{10

11}, Ashish Bajel¹⁰, Andrew Grigg^{3

12}

Affiliations

¹ Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
² The Peter Doherty Institute for Infection and Immunity, The University of Melbourne and Royal Melbourne Hospital, Melbourne, Victoria, Australia.
³ National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁴ Department of Haematology and Bone Marrow Transplantation, Westmead Hospital, Sydney, New South Wales, Australia.
⁵ Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia.
⁶ Sydney Cellular Therapies Laboratory, Westmead Hospital, Sydney, New South Wales, Australia.
⁷ Pharmacy Department, Royal North Shore Hospital, Sydney, New South Wales, Australia.
⁸ Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia.
⁹ NSW Health Pathology, Prince of Wales Hospital, Sydney, New South Wales, Australia.
¹⁰ Department of Clinical Haematology, Peter MacCallum Cancer Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
¹¹ Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
¹² Department of Clinical Haematology and Olivia Newton John Cancer Research Institute, Austin Hospital, Melbourne, Victoria, Australia.

PMID: 31403736
DOI: 10.1111/imj.14462

Abstract

Cytomegalovirus (CMV) viraemia continues to be a frequent complication in the post-haemopoietic stem cell transplantation period despite a low incidence of CMV end-organ disease. Several significant advances in the understanding and management of CMV infection have occurred in the last few years including improved diagnostics, monitoring of CMV immunity, availability of novel anti-CMV drugs, and emerging use of immunotherapies including CMV-specific T-cell infusions. In addition to reviewing these advances we also explore some of the more practical prescribing issues of the older and newer CMV drugs including cost, toxicity and drug interactions to help clinicians navigate this new era of CMV management.

Keywords: CMV immune monitoring; CMV-specific T-cell therapy; cytomegalovirus; haemopoietic stem cell transplantation; letermovir; maribavir.

Publication types

Review

MeSH terms

Antiviral Agents / therapeutic use
Cytomegalovirus
Cytomegalovirus Infections* / drug therapy
Hematopoietic Stem Cell Transplantation* / adverse effects
Humans
T-Lymphocytes

Substances

Antiviral Agents