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

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 m...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Delaney Wolfe, Qiuhong Zhao, Emma Siegel, Marcin Puto, Danielle Murphy, Julianna Roddy, Yvonne Efebera, Justin Tossey
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	cytomegalovirus graft versus host disease allogeneic letermovir hematopoietic cell transplantation Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/3f01727b5051476e8393962a49d95515
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:3f01727b5051476e8393962a49d95515
record_format	dspace
spelling	oai:doaj.org-article:3f01727b5051476e8393962a49d955152021-11-11T15:35:37ZLetermovir Prophylaxis and Cytomegalovirus Reactivation in Adult Hematopoietic Cell Transplant Recipients with and without Acute Graft Versus Host Disease10.3390/cancers132155722072-6694https://doaj.org/article/3f01727b5051476e8393962a49d955152021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5572https://doaj.org/toc/2072-6694Cytomegalovirus (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 (<i>n</i> = 119) and who developed aGVHD compared to a control group (<i>n</i> = 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], <i>p</i> < 0.001), reduced non-relapsed mortality (<i>p</i> = 0.04) and improved overall survival (<i>p</i> = 0.04). This data suggests that letermovir prophylaxis improves outcomes by preventing CS-CMVi in patients with aGVHD.Delaney WolfeQiuhong ZhaoEmma SiegelMarcin PutoDanielle MurphyJulianna RoddyYvonne EfeberaJustin TosseyMDPI AGarticlecytomegalovirusgraft versus host diseaseallogeneicletermovirhematopoietic cell transplantationNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5572, p 5572 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cytomegalovirus graft versus host disease allogeneic letermovir hematopoietic cell transplantation Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	cytomegalovirus graft versus host disease allogeneic letermovir hematopoietic cell transplantation Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Delaney Wolfe Qiuhong Zhao Emma Siegel Marcin Puto Danielle Murphy Julianna Roddy Yvonne Efebera Justin Tossey Letermovir Prophylaxis and Cytomegalovirus Reactivation in Adult Hematopoietic Cell Transplant Recipients with and without Acute Graft Versus Host Disease
description	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 (<i>n</i> = 119) and who developed aGVHD compared to a control group (<i>n</i> = 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], <i>p</i> < 0.001), reduced non-relapsed mortality (<i>p</i> = 0.04) and improved overall survival (<i>p</i> = 0.04). This data suggests that letermovir prophylaxis improves outcomes by preventing CS-CMVi in patients with aGVHD.
format	article
author	Delaney Wolfe Qiuhong Zhao Emma Siegel Marcin Puto Danielle Murphy Julianna Roddy Yvonne Efebera Justin Tossey
author_facet	Delaney Wolfe Qiuhong Zhao Emma Siegel Marcin Puto Danielle Murphy Julianna Roddy Yvonne Efebera Justin Tossey
author_sort	Delaney Wolfe
title	Letermovir Prophylaxis and Cytomegalovirus Reactivation in Adult Hematopoietic Cell Transplant Recipients with and without Acute Graft Versus Host Disease
title_short	Letermovir Prophylaxis and Cytomegalovirus Reactivation in Adult Hematopoietic Cell Transplant Recipients with and without Acute Graft Versus Host Disease
title_full	Letermovir Prophylaxis and Cytomegalovirus Reactivation in Adult Hematopoietic Cell Transplant Recipients with and without Acute Graft Versus Host Disease
title_fullStr	Letermovir Prophylaxis and Cytomegalovirus Reactivation in Adult Hematopoietic Cell Transplant Recipients with and without Acute Graft Versus Host Disease
title_full_unstemmed	Letermovir Prophylaxis and Cytomegalovirus Reactivation in Adult Hematopoietic Cell Transplant Recipients with and without Acute Graft Versus Host Disease
title_sort	letermovir prophylaxis and cytomegalovirus reactivation in adult hematopoietic cell transplant recipients with and without acute graft versus host disease
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/3f01727b5051476e8393962a49d95515
work_keys_str_mv	AT delaneywolfe letermovirprophylaxisandcytomegalovirusreactivationinadulthematopoieticcelltransplantrecipientswithandwithoutacutegraftversushostdisease AT qiuhongzhao letermovirprophylaxisandcytomegalovirusreactivationinadulthematopoieticcelltransplantrecipientswithandwithoutacutegraftversushostdisease AT emmasiegel letermovirprophylaxisandcytomegalovirusreactivationinadulthematopoieticcelltransplantrecipientswithandwithoutacutegraftversushostdisease AT marcinputo letermovirprophylaxisandcytomegalovirusreactivationinadulthematopoieticcelltransplantrecipientswithandwithoutacutegraftversushostdisease AT daniellemurphy letermovirprophylaxisandcytomegalovirusreactivationinadulthematopoieticcelltransplantrecipientswithandwithoutacutegraftversushostdisease AT juliannaroddy letermovirprophylaxisandcytomegalovirusreactivationinadulthematopoieticcelltransplantrecipientswithandwithoutacutegraftversushostdisease AT yvonneefebera letermovirprophylaxisandcytomegalovirusreactivationinadulthematopoieticcelltransplantrecipientswithandwithoutacutegraftversushostdisease AT justintossey letermovirprophylaxisandcytomegalovirusreactivationinadulthematopoieticcelltransplantrecipientswithandwithoutacutegraftversushostdisease
_version_	1718435173277630464

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

Ejemplares similares