Cytomegalovirus in haematopoietic cell transplantation - The troll is still there

Best Pract Res Clin Haematol. 2024 Sep;37(3):101565. doi: 10.1016/j.beha.2024.101565. Epub 2024 Jul 26.

Abstract

Patients undergoing allogeneic haematopoietic cell transplantation are prone to complications caused by viral infections. Cytomegalovirus (CMV) considerably impacts transplantation as it frequently requires antiviral intervention that evokes substantial side effects depending on the antiviral drug. Intermittent antiviral treatment may become necessary if CMV DNAemia cannot be permanently suppressed, and drug resistance may emerge that hampers and prolongs treatment. Despite sedulous endeavours, vaccination against CMV is not yet available. This review concisely summarises current approaches in managing CMV infection comprising risk factors, diagnostics including indications for resistance testing, and therapeutic options from antiviral drugs to virus-specific T cells.

Keywords: Acute leukaemia; Antiviral drugs; Cytomegalovirus; Drug resistance; Haematopoietic cell transplantation; Relapse risk; Virus-specific T cells.

Publication types

  • Review

MeSH terms

  • Allografts
  • Antiviral Agents* / therapeutic use
  • Cytomegalovirus Infections* / immunology
  • Cytomegalovirus Infections* / prevention & control
  • Cytomegalovirus Infections* / therapy
  • Cytomegalovirus*
  • Drug Resistance, Viral
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Risk Factors
  • T-Lymphocytes / immunology

Substances

  • Antiviral Agents