American Society for Transplantation and Cellular Therapy Series: #3—Prevention of Cytomegalovirus Infection and Disease After Hematopoietic Cell Transplantation

Hakki, Morgan; Aitken, Samuel L; Danziger‐Isakov, Lara; Michaels, Marian G.; Carpenter, Paul A.; Chemaly, Roy F.; Papanicolaou, Genovefa A.; Boeckh, Michael; Marty, Francisco M.

doi:10.1016/j.jtct.2021.05.001

Cited by 64 publications

(46 citation statements)

References 172 publications

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“…Subjects were treated according to institutional standards. 18 Letermovir prophylaxis for CMV was instituted at both centers in 2018. Subjects were included from 2 centers: Memorial Sloan Kettering Cancer Center and University of Miami Sylvester Comprehensive Cancer Center.…”

Section: Methodsmentioning

confidence: 99%

Improved GRFS after posttransplant cyclophosphamide-based vs ATG-based HLA-mismatched unrelated donor transplant

et al. 2022

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A common method to prevent graft-versus-host disease after allogeneic hematopoietic cell transplantation (HCT) from an HLA-mismatched unrelated donor (MMUD) is tacrolimus, methotrexate, and antithymocyte globulin (ATG). The use of posttransplant cyclophosphamide (PTCy) showed promise in a prospective trial for MMUD HCT. We compared 1-year graft-versus-host disease–free, relapse-free survival (GRFS) in 128 recipients of prophylaxis based on tacrolimus/methotrexate/ATG (ATG group, n = 46) vs PTCy, mycophenolate mofetil, and tacrolimus or sirolimus (PTCy group, n = 82) after MMUD HCT. Patients receiving HCT from a MMUD mismatched at ≥1 locus among HLA-A, HLA-B, HLA-C, and HLA-DRB1 were included. The 2 groups were well matched for HCT indication, high-risk disease, and HCT comorbidity index, whereas more patients on PTCy received bone marrow (50% vs 26%; P = .01) and >1 locus HLA-mismatched (30.5% vs 2.2%; P = .001) grafts. The 1-year GRFS was 16% (95% confidence interval (CI): 8%-31%) vs 54% (95% CI: 44%-66%; P < .001) in the ATG and PTCy groups, respectively. The multivariable adjusted hazard ratio for GRFS was 0.34 (95% CI: 0.21-0.55; P < .001) with the use of PTCy. The 1-year overall survival in the ATG group was 45% (95% CI: 32%-62%) vs 75% (95% CI: 66%-85%) in the PTCy group (P < .001). Relapse incidence was similar. One-year nonrelapse mortality was greater after ATG-based prophylaxis: 38% (95% CI: 23%-52%) vs 16% (95 CI: 9%-25%), P < .001. In summary, PTCy-based prophylaxis resulted in superior GRFS and overall survival in recipients of MMUD.

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Section: Methodsmentioning

confidence: 99%

Improved GRFS after posttransplant cyclophosphamide-based vs ATG-based HLA-mismatched unrelated donor transplant

et al. 2022

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“…CMV infection was diagnosed according to criteria based on underlying CMV risk characteristics: CMV DNA ≥100 copies/mL in peripheral blood by CMV PCR assay ( Hakki et al., 2021 ). CMV duration time was defined as an accumulation of CMV positive time.…”

Section: Methodsmentioning

confidence: 99%

Cytomegalovirus-specific neutralizing antibodies effectively prevent uncontrolled infection after allogeneic hematopoietic stem cell transplantation

et al. 2022

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“…Without anti-CMV prophylaxis, 60% to 70% of CMV-seropositive HCT recipients will experience CMV infection following transplantation (7). Thus, based on current guidelines (8,9), letermovir primary prophylaxis is highly recommended but if it cannot be used, CMV monitoring and pre-emptive therapy (PET) should be used over (val)ganciclovir or foscarnet primary prophylaxis. PET involves serial (often bi-weekly) blood monitoring for detectable CMV.…”

Section: Prophylaxis Versus Pre-emptive Therapy For Hct Recipients (6...mentioning

confidence: 99%

Cytomegalovirus infection in transplant recipients: newly approved additions to our armamentarium

Khawaja

Spallone

Kotton

et al. 2023

Clinical Microbiology and Infection

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American Society for Transplantation and Cellular Therapy Series: #3—Prevention of Cytomegalovirus Infection and Disease After Hematopoietic Cell Transplantation

Cited by 64 publications

References 172 publications

Improved GRFS after posttransplant cyclophosphamide-based vs ATG-based HLA-mismatched unrelated donor transplant

Improved GRFS after posttransplant cyclophosphamide-based vs ATG-based HLA-mismatched unrelated donor transplant

Cytomegalovirus-specific neutralizing antibodies effectively prevent uncontrolled infection after allogeneic hematopoietic stem cell transplantation

Cytomegalovirus infection in transplant recipients: newly approved additions to our armamentarium

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