{"title":"Reduction in Length of Hospital Stays for Allogeneic Hematopoietic Stem-Cell Transplantation in the Letermovir Era.","authors":"Hiroki Hosoi, Misato Tane, Tadashi Okamura, Shotaro Tabata, Ke Wan, Shogo Murata, Toshiki Mushino, Akinori Nishikawa, Takashi Sonoki","doi":"10.1111/tid.70008","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In recent years, letermovir has been routinely used for cytomegalovirus (CMV) infection prophylaxis in patients receiving allogeneic hematopoietic stem-cell transplantation (HSCT). The reduction effect of letermovir on CMV infection rates and the impact on survival have been studied, but other potential benefits of letermovir remain underexplored.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent first-time allogeneic HSCT between October 2013 and August 2023. We compared the length of hospital stay between eras before and after the introduction of letermovir (\"nonletermovir group\" and \"letermovir group,\" respectively). Secondary outcomes included clinically significant CMV infection rates and hospitalization costs.</p><p><strong>Results: </strong>A total of 59 patients were analyzed in the nonletermovir group and 65 patients in the letermovir group. The median length of hospital stay was 51 days in the nonletermovir group and 42 days in the letermovir group (p < 0.001). Among standard-risk disease patients, the letermovir group also had significantly shorter hospital stays (p = 0.0048). Additionally, the cumulative incidence of clinically significant CMV infection and grade II-IV acute graft-versus-host disease were both lower in the letermovir group. Hospitalization costs were not significantly different between the two groups.</p><p><strong>Conclusion: </strong>The length of hospital stays after HSCT was observed to be shorter following the introduction of letermovir in this study. This reduction in hospital stays did not decrease hospitalization costs in relation to allogeneic HSCT, but it may alleviate the burden on both patients and healthcare providers.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70008"},"PeriodicalIF":2.6000,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplant Infectious Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/tid.70008","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
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Abstract
Background: In recent years, letermovir has been routinely used for cytomegalovirus (CMV) infection prophylaxis in patients receiving allogeneic hematopoietic stem-cell transplantation (HSCT). The reduction effect of letermovir on CMV infection rates and the impact on survival have been studied, but other potential benefits of letermovir remain underexplored.
Methods: This retrospective study included patients who underwent first-time allogeneic HSCT between October 2013 and August 2023. We compared the length of hospital stay between eras before and after the introduction of letermovir ("nonletermovir group" and "letermovir group," respectively). Secondary outcomes included clinically significant CMV infection rates and hospitalization costs.
Results: A total of 59 patients were analyzed in the nonletermovir group and 65 patients in the letermovir group. The median length of hospital stay was 51 days in the nonletermovir group and 42 days in the letermovir group (p < 0.001). Among standard-risk disease patients, the letermovir group also had significantly shorter hospital stays (p = 0.0048). Additionally, the cumulative incidence of clinically significant CMV infection and grade II-IV acute graft-versus-host disease were both lower in the letermovir group. Hospitalization costs were not significantly different between the two groups.
Conclusion: The length of hospital stays after HSCT was observed to be shorter following the introduction of letermovir in this study. This reduction in hospital stays did not decrease hospitalization costs in relation to allogeneic HSCT, but it may alleviate the burden on both patients and healthcare providers.
期刊介绍：
Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal.
Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.
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