Real-life experiences of letermovir prophylaxis for cytomegalovirus infection in patients after hematopoietic stem cell transplantation: Polish Acute Leukemia Group (PALG) analysis

Łojko, Anna; Styczyński, Jan; Nasiłowska-Adamska, Barbara; Mańko, Joanna; Kałwak, Krzysztof; Mensah-Glanowska, Patrycja; Dybko, Jarosław; Majcherek, Maciej; Czyż, Anna; Pluta, Agnieszka; Gil, Lidia

doi:10.5603/ahp.a2022.2047

Cited by 3 publications

(6 citation statements)

References 22 publications

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“…LMV is a drug that changes the paradigm of PET use in favor of prophylaxis as first-line management strategy against CMV [7,47,49]. A Polish experience with LMV prophylaxis, published recently, confirms its low toxicity with no myelosuppressive (or any other) adverse effect and good tolerability [50]. Our own experience with more than 30 patients treated with LMV seems to confirm its efficacy and safety (data not published).…”

Section: Post-transplantation Work-up and CMV Prophylaxismentioning

confidence: 75%

How to manage cytomegalovirus reactivation/infection after hematopoietic stem cell transplantation: practical tips for clinicians

Włodarczyk

Helbig

2023

Acta Haematol Pol.

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Cytomegalovirus (CMV) reactivation is one of the most common and life-threatening complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). It is associated with an increased risk of transplantation failure, non-relapse mortality (NRM), and lower overall survival (OS) than in patients without CMV reactivation, even in the era of pre-emptive antiviral treatment. Numerous risk factors for CMV reactivation in the setting of allo-HSCT have been identified. Donor/recipient CMV serological status remains the main risk factor influencing the incidence and mortality of CMV disease after transplantation. Proper selection of donor and recipient, regular and careful monitoring, an early intervention in CMV reactivation, and rapid and effective treatment when the disease develops, remain crucial to decrease the risk of post-transplantation CMV reactivation/disease. The introduction of letermovir as CMV prophylaxis has reduced NRM and improved OS.Herein we present practical tips as to how to manage CMV reactivation/disease after allo-HSCT through an illustrative case report, with a focus on the risk factors present before and during the procedure.

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Section: Post-transplantation Work-up and CMV Prophylaxismentioning

confidence: 75%

How to manage cytomegalovirus reactivation/infection after hematopoietic stem cell transplantation: practical tips for clinicians

Włodarczyk

Helbig

2023

Acta Haematol Pol.

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“…3 D ). Five and 1 studies, 52 respectively, were included for the analysis of CMV infection at any time after HSCT in adults and children, and the incidence of CMV infection at any time was 6% (95% CI, 3%–13%) in adults, which was comparable with that in children (20%, Fig. 3 E ).…”

Section: Resultsmentioning

confidence: 91%

“…Six studies including 1188 patients reported the incidence of CMV disease at 6 months after allo-HSCT. 29 – 32 , 45 , 52 The incidence of CMV disease at 6 months after allo-HSCT was 3% (95% CI, 1%–9%, Fig. 4 D ).…”

Section: Resultsmentioning

confidence: 98%

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Efficacy and safety of letermovir prophylaxis for cytomegalovirus infection after hematopoietic stem cell transplantation

Li,

Zhang,

Shen

et al. 2024

Blood Science

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Letermovir is a specific inhibitor of cytomegalovirus (CMV) terminase complex. Several studies have reported that letermovir can effectively prevent CMV activation after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We aimed to identify the efficacy and safety of letermovir prophylaxis for CMV infection after allo-HSCT with a systemic review and meta-analysis. A literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. PubMed and Embase databases were searched. A total of 28 studies were included. The incidence of CMV activation at 14 weeks after HSCT was 0.10 (95% confidence interval [CI], 0.06–0.18), which was 0.10 (95% CI, 0.04–0.21) and 0% in adult and children (2 studies were included and both of them were 0%). In addition, the incidence of CMV activation at 14 weeks after allo-HSCT was 0.11 (95% CI, 0.06–0.21) and 0.07 (only 1 study included), respectively, in retrospective and prospective studies. The incidence of CMV activation at 100 and 200 days after HSCT was 0.23 (95% CI, 0.16–0.33) and 0.49 (95% CI, 0.32–0.67), respectively. The incidence of CMV disease at 14 weeks and at 6 months after HSCT was 0.01 (95% CI, 0.01–0.02) and 0.03 (95% CI, 0.01–0.09), respectively. Thus, our systemic review and meta-analysis suggested that letermovir prophylaxis was safe and effective for CMV activation after allo-HSCT.

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“…Cytomegalovirus (CMV) infection is a major complication after allogeneic hematopoietic cell transplantation (allo-HCT), and a serious trigger for other sequelae [1][2][3]. The introduction of letermovir into the prophylaxis of CMV infection has led to a large reduction of the CMV reactivation rate in seropositive adult patients after allo-HCT [4][5]. This effect obviously means fewer direct and indirect complications caused by the virus [6][7][8].…”

mentioning

confidence: 99%

Revolution in management of CMV infection after hematopoietic cell transplantation

Styczyński

2023

Acta Haematol Pol.

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Real-life experiences of letermovir prophylaxis for cytomegalovirus infection in patients after hematopoietic stem cell transplantation: Polish Acute Leukemia Group (PALG) analysis

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 22 publications

How to manage cytomegalovirus reactivation/infection after hematopoietic stem cell transplantation: practical tips for clinicians

How to manage cytomegalovirus reactivation/infection after hematopoietic stem cell transplantation: practical tips for clinicians

Efficacy and safety of letermovir prophylaxis for cytomegalovirus infection after hematopoietic stem cell transplantation

Revolution in management of CMV infection after hematopoietic cell transplantation

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