Letermovir for Cytomegalovirus Prophylaxis in Hematopoietic-Cell Transplantation

Abstract

Letermovir, as compared with placebo, was effective in reducing the incidence of CMV infection in recipients of allogeneic hematopoietic-cell transplants. The highest dose (240 mg per day) had the greatest anti-CMV activity, with an acceptable safety profile. (Funded by AiCuris; ClinicalTrials.gov number, NCT01063829.).

Role of cytomegalovirus (CMV)-specific polyfunctional CD8+ T-cells and antibodies neutralizing virus epithelial infection in the control of CMV infection in an allogeneic stem-cell transplantation setting

“…This has renewed interest in antiviral prophylaxis for the prevention of CMV-related morbidity in Allo-SCT recipients (Chemaly et al, 2014). The identification of biomarkers predicting the occurrence of CMV viraemia (particularly those episodes requiring the administration of pre-emptive antiviral therapy) would allow the inception of antiviral prophylaxis on an individual basis according to the patient's risk (targeted prophylaxis).…”

Characterization of Multiple Cytomegalovirus Drug Resistance Mutations Detected in a Hematopoietic Stem Cell Transplant Recipient by Recombinant Phenotyping

“…Our results highlight the need to develop new antiviral strategies that target other viral proteins (18).…”

Early cytomegalovirus reactivation remains associated with increased transplant-related mortality in the current era: a CIBMTR analysis

“…For example, pharmaceutical agents with better efficacy and reduced toxicity profiles would lessen viral-associated morbidity and mortality. [35][36][37] In this regard, viral-directed adoptive cellular immunotherapy has emerged to advance the therapeutic approach to viral disease in allogeneic HCT 38,39 and to decrease the need for conventional pharmaceutical agents with harmful end-organ effects. 39,40 This study has several limitations.…”