Gyuri Han, Anat Stern, Yeon Joo Lee, Yuxuan Li, Parastoo B Dahi, Roni Tamari, Boglarka Gyurkocza, Ann A Jakubowski, Esperanza B Papadopoulos, Brian Shaffer, Miguel-Angel Perales, Karam M Obeid, Jo-Anne H Young, Genovefa A Papanicolaou
{"title":"来替莫韦对高风险异基因造血细胞移植(HCT)受者复发 CMV 的预防。","authors":"Gyuri Han, Anat Stern, Yeon Joo Lee, Yuxuan Li, Parastoo B Dahi, Roni Tamari, Boglarka Gyurkocza, Ann A Jakubowski, Esperanza B Papadopoulos, Brian Shaffer, Miguel-Angel Perales, Karam M Obeid, Jo-Anne H Young, Genovefa A Papanicolaou","doi":"10.1016/j.jtct.2024.12.010","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We evaluated letermovir (LTV) for secondary prophylaxis for cytomegalovirus (CMV) in allogeneic hematopoietic cell transplant recipients (HCT) at high-risk for CMV recurrence.</p><p><strong>Methods: </strong>Open-label study conducted at Memorial Sloan Kettering Cancer Center and the University of Minnesota. Patients with clinically significant CMV infection (cs-CMVi) and ≥1 high-risk criteria for CMV who achieved viral suppression with standard CMV antivirals, received letermovir (LTV) secondary prophylaxis for up to 14 weeks. The primary endpoint was cs-CMVi at week 14. Secondary endpoints included, LTV resistance, CMV end-organ disease (EOD), CMV-related death and LTV related Adverse Events (AE) at week 14.</p><p><strong>Results: </strong>Thirty-six patients were analyzed (CMV seropositive 33, T-cell depleted HCT 25, cord blood allograft 5) were analyzed. By week 14, 5 patients met the primary endpoint of cs-CMVi, for a cumulative incidence of 14.9% (95% confidence interval 2.6 - 27.1). Four patients developed LTV breakthrough cs-CMVi (including 2 patients with confirmed LTV resistance). The remaining patient developed rebound cs-CMVI after premature discontinuation of LTV due to enrollment in a clinical trial. There were no cases of CMV EOD or CMV-related deaths or LTV related AE by week 14 or by week 24.</p><p><strong>Conclusions: </strong>Our data supports that LTV secondary prophylaxis is safe and effective in high-risk HCT recipients.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Letermovir for prevention of recurrent CMV in high-risk allogeneic hematopoietic cell transplant (HCT) recipients.\",\"authors\":\"Gyuri Han, Anat Stern, Yeon Joo Lee, Yuxuan Li, Parastoo B Dahi, Roni Tamari, Boglarka Gyurkocza, Ann A Jakubowski, Esperanza B Papadopoulos, Brian Shaffer, Miguel-Angel Perales, Karam M Obeid, Jo-Anne H Young, Genovefa A Papanicolaou\",\"doi\":\"10.1016/j.jtct.2024.12.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>We evaluated letermovir (LTV) for secondary prophylaxis for cytomegalovirus (CMV) in allogeneic hematopoietic cell transplant recipients (HCT) at high-risk for CMV recurrence.</p><p><strong>Methods: </strong>Open-label study conducted at Memorial Sloan Kettering Cancer Center and the University of Minnesota. Patients with clinically significant CMV infection (cs-CMVi) and ≥1 high-risk criteria for CMV who achieved viral suppression with standard CMV antivirals, received letermovir (LTV) secondary prophylaxis for up to 14 weeks. The primary endpoint was cs-CMVi at week 14. Secondary endpoints included, LTV resistance, CMV end-organ disease (EOD), CMV-related death and LTV related Adverse Events (AE) at week 14.</p><p><strong>Results: </strong>Thirty-six patients were analyzed (CMV seropositive 33, T-cell depleted HCT 25, cord blood allograft 5) were analyzed. By week 14, 5 patients met the primary endpoint of cs-CMVi, for a cumulative incidence of 14.9% (95% confidence interval 2.6 - 27.1). Four patients developed LTV breakthrough cs-CMVi (including 2 patients with confirmed LTV resistance). The remaining patient developed rebound cs-CMVI after premature discontinuation of LTV due to enrollment in a clinical trial. There were no cases of CMV EOD or CMV-related deaths or LTV related AE by week 14 or by week 24.</p><p><strong>Conclusions: </strong>Our data supports that LTV secondary prophylaxis is safe and effective in high-risk HCT recipients.</p>\",\"PeriodicalId\":23283,\"journal\":{\"name\":\"Transplantation and Cellular Therapy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-12-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplantation and Cellular Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jtct.2024.12.010\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation and Cellular Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jtct.2024.12.010","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Letermovir for prevention of recurrent CMV in high-risk allogeneic hematopoietic cell transplant (HCT) recipients.
Background: We evaluated letermovir (LTV) for secondary prophylaxis for cytomegalovirus (CMV) in allogeneic hematopoietic cell transplant recipients (HCT) at high-risk for CMV recurrence.
Methods: Open-label study conducted at Memorial Sloan Kettering Cancer Center and the University of Minnesota. Patients with clinically significant CMV infection (cs-CMVi) and ≥1 high-risk criteria for CMV who achieved viral suppression with standard CMV antivirals, received letermovir (LTV) secondary prophylaxis for up to 14 weeks. The primary endpoint was cs-CMVi at week 14. Secondary endpoints included, LTV resistance, CMV end-organ disease (EOD), CMV-related death and LTV related Adverse Events (AE) at week 14.
Results: Thirty-six patients were analyzed (CMV seropositive 33, T-cell depleted HCT 25, cord blood allograft 5) were analyzed. By week 14, 5 patients met the primary endpoint of cs-CMVi, for a cumulative incidence of 14.9% (95% confidence interval 2.6 - 27.1). Four patients developed LTV breakthrough cs-CMVi (including 2 patients with confirmed LTV resistance). The remaining patient developed rebound cs-CMVI after premature discontinuation of LTV due to enrollment in a clinical trial. There were no cases of CMV EOD or CMV-related deaths or LTV related AE by week 14 or by week 24.
Conclusions: Our data supports that LTV secondary prophylaxis is safe and effective in high-risk HCT recipients.