Incidence of CMV Replication and the Role of Letermovir Primary/Secondary Prophylaxis in the Early Phase After Allogeneic Hematopoietic Stem Cell Transplantation - A Single Centre Study

Anticancer Res. 2020 Oct;40(10):5909-5917. doi: 10.21873/anticanres.14611.

Abstract

Background/aim: Cytomegalovirus (CMV) replication may cause life-threatening complications after allogeneic haematopoietic stem cell transplantation (allo-HSCT). The aim of the study was to characterize CMV events, and the outcome of letermovir (LTV) CMV prophylaxis.

Patients and methods: In this retrospective analysis of patients treated with an allo-HSCT between 2010 and 2020, we determined plasma CMV events, as well as associated risk factors.

Results: We identified 423 patients who had undergone allo-HSCT between 2010 and 2020. CMV DNAemia was found in 130/423 (30.7%) of patients. CMV reactivation rate was significantly higher in patients with acute graft-versus-host disease, HLA mismatch, and CMV IgG seropositivity of donors and recipients. Among 42 patients receiving LTV prophylaxis those, 5 (11.9%) showed CMV DNAemia under LTV versus 87/353 (24.6%) in a control group.

Conclusion: Despite the development of better approaches with weekly monitoring and early treatment initiation, CMV reactivations play an important role after allo-HSCT.

Keywords: Cytomegalovirus; allogeneic hematopoietic stem cell transplantation; letermovir.

MeSH terms

  • Acetates / administration & dosage*
  • Adult
  • Aged
  • Cytomegalovirus / drug effects*
  • Cytomegalovirus / pathogenicity
  • Cytomegalovirus Infections / blood
  • Cytomegalovirus Infections / drug therapy*
  • Cytomegalovirus Infections / etiology
  • Cytomegalovirus Infections / virology
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Quinazolines / administration & dosage*
  • Transplantation, Homologous / adverse effects
  • Virus Replication / drug effects

Substances

  • Acetates
  • Quinazolines
  • letermovir