Burden of cytomegalovirus disease in allogeneic hematopoietic cell transplant recipients: a national, matched cohort study in an inpatient setting

Hakimi, Z.; Ferchichi, S.; Aballéa, Samuel; Odeyemi, Isaac; Toumi, Mondher; English, Marci; Yakoub-Agha, Ibrahim

doi:10.1016/j.retram.2018.08.004

Cited by 6 publications

(8 citation statements)

References 34 publications

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“…No association was found between treated CMV infection and relapse of underlying disease. This was consistent with the analyses of other cohorts, which did not report an increase in relapse after CMV infection 7,17,21,24 . As previously reported in the cohort of Sousa et al, 17 we did not observe a relationship between treated CMV infection and acute or chronic GvHD.…”

Section: Discussionsupporting

confidence: 93%

“…This was consistent with the analyses of other cohorts, which did not report an increase in relapse after CMV infection. 7,17,21,24 As previously reported in the cohort of Sousa et al, 17 we did not observe a relationship between treated CMV infection and acute or chronic GvHD. However, dates of events were missing in half the patients with chronic GvHD and statistical analysis could thus have been underpowered.…”

Section: Discussionsupporting

confidence: 84%

“…These considerations notwithstanding, our economic analysis suggests that CMV infection contributes to significant higher hospital costs for CMV‐seropositive patients. This is in line with other medico‐economic analyses performed in France and other countries that show an increase of the financial burden due to CMV infection in allo‐HCT patients managed with a preemptive strategy 24 . A US study concluded that CMV infection in recipients of allo‐HCT led to an additional cost of $58 000‐$74 000 per patient within the first 6 months due to antiviral medications and longer hospitalizations 6 .…”

Section: Discussionsupporting

confidence: 83%

“…This is in line with other medico-economic analyses performed in France and other countries that show an increase of the financial burden due to CMV infection in allo-HCT patients managed with a preemptive strategy. 24 A US study PEFFAULT DE LATOUR ET AL.…”

Section: Discussionmentioning

confidence: 99%

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Clinical and economic impact of treated CMV infection in adult CMV‐seropositive patients after allogeneic hematopoietic cell transplantation

Latour

Chevallier

Blaise

et al. 2020

Journal of Medical Virology

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Objective Recipients of allogeneic hematopoietic stem cell transplantation (allo‐HCT) with positive cytomegalovirus (CMV) serology are at increased risk of morbidity and mortality. The primary objective of this study was to assess the association between treated CMV infection and overall mortality within 1 year after allo‐HCT in adult CMV‐seropositive Recipients (R+). Secondary objectives included overall 5‐year mortality after allo‐HCT, risk factors for treated CMV infection, associations between treated CMV infection and allo‐HCT complications and medical costs. Methods A multicenter retrospective cohort study was conducted in adult CMV‐seropositive recipients (R+) who underwent to allo‐HCT between 1st January 2010 and 31st December 2014. Results Five hundred seventy two CMV‐seropositive patients (mean age, 50.2 years) undergoing allo‐HCT between 2010 and 2014 were included; 55.9% of donors were CMV seropositive. CMV infection treated with antiviral therapy was reported in 227 patients (39.7%) after transplantation. One‐year overall mortality was significantly increased in patients with treated CMV infections (hazard ratio, 1.86; 95% CI, 1.16‐3.00; P = .011). Mean medical costs during the first post‐HCT year were higher in patients with CMV infection (€46 853 vs €31 318; P < .0001). Conclusion In this large cohort of CMV‐seropositive patients undergoing allo‐HCT, treated CMV infection was significantly associated with an increased 1‐year risk of overall mortality, with increased length of stay and with hospitalization cost. The burden of CMV disease in allo‐HCT could be reduced in the future by appropriate prophylactic strategies.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Clinical and economic impact of treated CMV infection in adult CMV‐seropositive patients after allogeneic hematopoietic cell transplantation

Latour

Chevallier

Blaise

et al. 2020

Journal of Medical Virology

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“…Cytomegalovirus (CMV) infection is a common post-transplant complication that increases the risk of graft dysfunction or rejection and mortality. [1][2][3][4] CMV infection has been reported in approximately 30% of patients undergoing allogeneic hematopoietic stem cell transplant (HSCT), and up to 75% of patients undergoing solid organ transplant (SOT). 3 The risk factors for CMV infection include serological mismatch between the donor and recipient, intense immunosuppression, use of lymphocyte-depleting antibodies, acute rejection, advanced age, human leukocyte antigens mismatch, and other concurrent infections.…”

Section: Introductionmentioning

confidence: 99%

Cost‐effectiveness of maribavir versus conventional antiviral therapies for post‐transplant refractory cytomegalovirus infection with or without genotypic resistance: A US perspective

Schultz,

Kotton,

Jutlla

et al. 2024

Journal of Medical Virology

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This study evaluated the cost‐effectiveness of maribavir versus investigator‐assigned therapy (IAT; valganciclovir/ganciclovir, foscarnet, or cidofovir) for post‐transplant refractory cytomegalovirus (CMV) infection with or without resistance. A two‐stage Markov model was designed using data from the SOLSTICE trial (NCT02931539), real‐world multinational observational studies, and published literature. Stage 1 (0–78 weeks) comprised clinically significant CMV (csCMV), non‐clinically significant CMV (n‐csCMV), and dead states; stage 2 (78 weeks–lifetime) comprised alive and dead states. Total costs (2022 USD) and quality‐adjusted life years (QALYs) were estimated for the maribavir and IAT cohorts. An incremental cost‐effectiveness ratio was calculated to determine cost‐effectiveness against a willingness‐to‐pay threshold of $100 000/QALY. Compared with IAT, maribavir had lower costs ($139 751 vs $147 949) and greater QALYs (6.04 vs 5.83), making it cost‐saving and more cost‐effective. Maribavir had higher acquisition costs compared with IAT ($80 531 vs $65 285), but lower costs associated with administration/monitoring ($16 493 vs $27 563), adverse events (AEs) ($11 055 vs $16 114), hospitalization ($27 157 vs $33 905), and graft loss ($4516 vs $5081), thus making treatment with maribavir cost‐saving. Maribavir‐treated patients spent more time without CMV compared with IAT‐treated patients (0.85 years vs 0.68 years), leading to lower retreatment costs for maribavir (cost savings: −$42 970.80). Compared with IAT, maribavir was more cost‐effective for transplant recipients with refractory CMV, owing to better clinical efficacy and avoidance of high costs associated with administration, monitoring, AEs, and hospitalizations. These results can inform healthcare decision‐makers on the most effective use of their resources for post‐transplant refractory CMV treatment.

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Effective Letermovir Prophylaxis of CMV infection post allogeneic hematopoietic cell transplantation: Results from the French temporary authorization of use compassionate program

Beauvais

Robin

Thiébaut

et al. 2022

Journal of Clinical Virology

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Burden of cytomegalovirus disease in allogeneic hematopoietic cell transplant recipients: a national, matched cohort study in an inpatient setting

Cited by 6 publications

References 34 publications

Clinical and economic impact of treated CMV infection in adult CMV‐seropositive patients after allogeneic hematopoietic cell transplantation

Clinical and economic impact of treated CMV infection in adult CMV‐seropositive patients after allogeneic hematopoietic cell transplantation

Cost‐effectiveness of maribavir versus conventional antiviral therapies for post‐transplant refractory cytomegalovirus infection with or without genotypic resistance: A US perspective

Effective Letermovir Prophylaxis of CMV infection post allogeneic hematopoietic cell transplantation: Results from the French temporary authorization of use compassionate program

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