Letermovir Prophylaxis and Cytomegalovirus Reactivation in Adult Hematopoietic Cell Transplant Recipients with and without Acute Graft Versus Host Disease

Cancers

卷:13

Yvonne Efebera¹  Delaney Wolfe¹  Marcin Puto¹  Danielle Murphy¹  Julianna Roddy¹  Justin Tossey¹  Emma Siegel¹  Qiuhong Zhao¹ 

[1] Comprehensive Cancer Center, James Cancer Hospital Solove Research Institute, The Ohio State University, 460 West 10th St., Columbus, OH 43210, USA;

关键词: cytomegalovirus;    graft versus host disease;    allogeneic;    letermovir;    hematopoietic cell transplantation;   

DOI  :  10.3390/cancers13215572

来源: DOAJ

【 摘 要 】

Cytomegalovirus (CMV) is the most clinically significant infection after allogeneic hematopoietic-cell transplantation (allo-HCT) and is associated with increased mortality. The risk for CMV reactivation increases with graft versus host disease (GVHD). GVHD contributes to significant morbidity and mortality and is treated with immunosuppressive therapies that can further increase CMV infection risk. Prophylaxis with letermovir, an oral antiviral approved to prevent CMV, has been shown to decrease the incidence of CMV infection post-allo-HCT in patients at high risk of CMV reactivation, but there is a lack of data confirming this benefit in patients with GVHD. In this single-center, retrospective study, we assessed the incidence of clinically significant CMV infection (CS-CMVi) in allo-HCT patients who received letermovir prophylaxis (n = 119) and who developed aGVHD compared to a control group (n = 143) who did not receive letermovir. Among aGVHD patients, letermovir prophylaxis decreased CS-CMVi in patients with aGVHD (HR 0.08 [95% CI 0.03–0.27], p < 0.001), reduced non-relapsed mortality (p = 0.04) and improved overall survival (p = 0.04). This data suggests that letermovir prophylaxis improves outcomes by preventing CS-CMVi in patients with aGVHD.

【 授权许可】

Unknown