[Maribavir treatment for refractory and drug-intolerant cytomegalovirus viremia and disease after allogeneic hematopoietic stem cell transplantation: a clinical analysis of 25 cases]

Zhonghua Xue Ye Xue Za Zhi. 2024 Nov 14;45(11):1010-1015. doi: 10.3760/cma.j.cn121090-20240919-00355.
[Article in Chinese]

Abstract
in English, Chinese

Objective: To investigate the safety and efficacy of maribavir for the treatment of CMV viremia and CMV disease refractory or intolerant to conventional antiviral drugs after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: This study retrospectively analyzed the clinical characteristics and outcomes of CMV viremia and CMV disease refractory or intolerant to conventional antiviral drugs after allo-HSCT treated with maribavir at Hebei Yanda Lu Daopei Hospital from April 2024 to September 2024. Result: A total of 25 patients received maribavir, including 21 haploidentical transplants, two sibling HLA-matched transplants, and 2 HLA-matched unrelated transplants. Among them, 21, 2, and 2 patients received the first, second, and third transplants, respectively. The median time to the onset of CMV viremia and CMV disease was 120.5 (6-298) days post-transplantation. The median peak plasma CMV copy number was 6 400 copies/ml (range: 1 100-650 000 copies/ml). Six patients were diagnosed with CMV disease. Maribavir was administered after a median of 9.5 (1-41) days after CMV infection. The median duration of maribavir administration was 11.5 (6-43) days. Post-treatment, maribavir was effective in 25 (100%) patients. Two patients experienced grade 1 taste abnormalities, and one patient experienced grade 2 myelosuppression. Conclusion: The application of maribavir after allo-HSCT for treating refractory, drug-intolerant CMV viremia and CMV disease is safe and effective.

目的： 探讨马立巴韦治疗异基因造血干细胞移植（allo-HSCT）后难治性、对常规抗病毒药物不耐受的巨细胞病毒（cytomegalovirus，CMV）血症和CMV病的安全性和有效性。 方法： 回顾性分析2024年4月至2024年9月在河北燕达陆道培医院马立巴韦治疗allo-HSCT后的难治性、对常规抗病毒药物不耐受的CMV血症和CMV病的结局。 结果： 接受马立巴韦治疗的25例患者，其中亲缘单倍型移植21例，同胞全合移植2例，非血缘移植2例。1次移植21例，2次移植2例和3次移植2例。患者发生CMV血症的中位时间为移植后120.5（6~298）d，血浆CMV最高拷贝中位数为6 400（1 100~650 000）拷贝/ml。6例患者诊断CMV病。患者在CMV感染后的9.5（1~41）d开始使用马立巴韦。使用马立巴韦持续中位时间为11.5（6~43）d。25例患者治疗均有效。2例患者发生1级的味觉异常，1例发生2级骨髓抑制。 结论： allo-HSCT后难治性、药物不耐受的CMV血症和CMV病患者应用马立巴韦治疗安全有效。.

Keywords: Allogeneic hematopoietic stem cell transplantation; Cytomegalovirus; Maribavir.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Antiviral Agents* / therapeutic use
  • Benzamides / therapeutic use
  • Benzimidazoles / therapeutic use
  • Cytomegalovirus
  • Cytomegalovirus Infections* / drug therapy
  • Dichlororibofuranosylbenzimidazole / analogs & derivatives
  • Female
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Ribonucleosides / therapeutic use
  • Transplantation, Homologous
  • Viremia*

Substances

  • Antiviral Agents
  • maribavir
  • Ribonucleosides
  • Benzimidazoles
  • Benzamides
  • Dichlororibofuranosylbenzimidazole