Letermovir use in children after hematopoietic cell transplantation: summary of reported data

Styczyński, Tomasz; Sadlok, Jagoda; Richert-Przygońska, Monika; Czyżewski, K

doi:10.5603/ahp.a2023.0004

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…Еще одну проблему для реципиентов ТГСК детского возраста представляют ограничения к назначению противовирусных препаратов детям [18]. Так, доказавший свою эффективность в качестве профилактики и превентивной терапии ЦМВ-инфекции у взрослых летермовир может применяться у детей только «off-label», однако клинические исследования демонстрируют его безопасность и эффективность у детей [19].…”

Section: Introductionunclassified

Reactivation of cytomegalovirus, human herpes virus, and Epstein-Barr virus infections after hemapoietic stem cell transplantation in children

Antonova,

Pobegalova,

Gorchakova

et al. 2024

jour

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Study objective: to evaluate frequency of CMV, HHV-6, and EBV reactivation in children within 60 days after HSCT.Materials and methods: The study was carried out in Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology, and Transplantation of the Pavlov First Saint Petersburg State Medical University We analyzed 95 medical records of pediatric patients who underwent HSCT in 2021. Pretransplant serostatus for CMV, EBV, HHV-6 was studied, as well as the frequency and timing of virus reactivation after transplantation. In the prospective part, 35 children aged from 1 to 17 years were enrolled. The pretransplant evaluation included detection of anti-CMV, anti-HHV-6, and anti-EBV IgM and IgG by ELISA, and blood PCR for viremia. DNA of herpes viruses was identified by quantitative blood PCR on the day of HSCT, and then 10, 20, 30 and 60 days after HSCT. The number of viral DNA copies was calculated per 105 cells. Statistical analysis was carried out using SPSS Statistics 22 software package.Results: On pre-transplant evaluation, 47 of 95 pediatric patients were tested for CMV with positive result in 36 children, 27 patients were tested for EBV and 17 were positive. HHV-6 DNA was detected in 3 of 25 patientsMostly, reactivation of herpes viruses occurred in the early period up to 60 days. HHV-6 reactivation was observed on average 25±4 days after transplantation, significantly earlier than for CMV and EBV.In a prospective study, reactivation of CMV, HHV-6, and EBV was revealed in 28 (80%) patients within 60 days of transplantation, with a maximum number of patients in 20 days after HSCT.A trend toward an increase in CMV and HHV-6 concentration in blood was observed on days 10 and 20 after HSCT, with a maximum viral load of HHV-6 and minimal EBV replicative activity. Clinically significant manifestations of herpesvirus infection were diagnosed in 19 (54.3%) patients.Conclusion: High seropositivity for CMV and EBV was revealed in children before transplantation. Herpes viruses reactivation occurs early in post-transplant period, on the 20th day after HSCT, HHV-6 in forms of mono- and mixed infection predominates with a trend toward increasing viral load.

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Section: Introductionunclassified

Reactivation of cytomegalovirus, human herpes virus, and Epstein-Barr virus infections after hemapoietic stem cell transplantation in children

Antonova,

Pobegalova,

Gorchakova

et al. 2024

jour

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“…3 Apart from Chen et al study, 1 between 2019 and 2023 total 11 papers were published on use of letermovir in prophylaxis in pediatric patients after HCT, including overall 64 patients. [4][5][6][7][8][9][10][11][12][13][14] In updated summary of these reported cases, 15 clinically significant CMV infection has occurred only in two of 64 (3.1%) patients. This is much lower than in the pivotal adult study (7.7% at week 14, and 37.5% at week 24) 2 and in Chen et al study (9.8% at day +180).…”

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confidence: 96%

Comment on: Letermovir for Cytomegalovirus prophylaxis in pediatric hematopoietic cell transplantation

Styczynski

2023

Pediatric Blood & Cancer

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“…Progress is still being maintained. Recent trials have shown the safety and efficacy of letermovir use for prolonged (200 days) prophylaxis, and also in other patient populations such as children, as well as in secondary prophylaxis [10].…”

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confidence: 99%

Revolution in management of CMV infection after hematopoietic cell transplantation

Styczyński

2023

Acta Haematol Pol.

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Letermovir use in children after hematopoietic cell transplantation: summary of reported data

Abstract: This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited.

Cited by 3 publications

References 12 publications

Reactivation of cytomegalovirus, human herpes virus, and Epstein-Barr virus infections after hemapoietic stem cell transplantation in children

Reactivation of cytomegalovirus, human herpes virus, and Epstein-Barr virus infections after hemapoietic stem cell transplantation in children

Comment on: Letermovir for Cytomegalovirus prophylaxis in pediatric hematopoietic cell transplantation

Revolution in management of CMV infection after hematopoietic cell transplantation

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