{"title":"莱特莫韦与更昔洛韦预防在接受同种异体造血干细胞移植的青少年患者中的实际疗效和安全性：一项单中心观察性研究","authors":"Ziwei Xu, Xuan Lu, Huafang Wang","doi":"10.3389/fcimb.2025.1558637","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficacy and safety of letermovir and ganciclovir for cytomegalovirus (CMV) prophylaxis in adolescent patients (aged 14-17 years) undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT).</p><p><strong>Methods: </strong>This observational and single-center study collected data from February 2023 and April 2024.</p><p><strong>Results: </strong>The cumulative incidence of CMV DNAemia following HSCT was 44.4% in the letermovir group (n=20) and 66.3% in the control group (n=32) receiving ganciclovir. Notably, the cumulative incidence of clinically significant CMV infection (csCMVi) was significantly reduced in the letermovir group compared with control patients (11.0% vs 41.3%, p=0.021). Among patients diagnosed with grades II-IV acute graft-versus-host disease (aGVHD), a significantly lower proportion of individuals in the letermovir group presented CMV DNAemia than in the control group (20.0% vs 73.3%, p=0.013). The common adverse events observed in the letermovir group were aGVHD (60.0%), diarrhea (25.0%), and nausea (15.0%). Leukopenia was reported in only one patient, and did not necessitate an adjustment of letermovir dosage.</p><p><strong>Conclusions: </strong>In this single-center real-world study, letermovir exhibited a favourable efficacy and safety profile for CMV prophylaxis in adolescent patients undergoing HSCT. However, further prospective multi-center studies are warranted to validate our conclusion in adolescent patients.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"15 ","pages":"1558637"},"PeriodicalIF":4.6000,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188444/pdf/","citationCount":"0","resultStr":"{\"title\":\"Real-world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation: a single center observational study.\",\"authors\":\"Ziwei Xu, Xuan Lu, Huafang Wang\",\"doi\":\"10.3389/fcimb.2025.1558637\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To compare the efficacy and safety of letermovir and ganciclovir for cytomegalovirus (CMV) prophylaxis in adolescent patients (aged 14-17 years) undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT).</p><p><strong>Methods: </strong>This observational and single-center study collected data from February 2023 and April 2024.</p><p><strong>Results: </strong>The cumulative incidence of CMV DNAemia following HSCT was 44.4% in the letermovir group (n=20) and 66.3% in the control group (n=32) receiving ganciclovir. 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引用次数: 0
摘要
目的：比较莱特莫韦和更昔洛韦在14-17岁接受同种异体造血干细胞移植（allogenic hematopoietic stem cell transplantation, alloo - hsct）的青少年患者中预防巨细胞病毒（CMV）的疗效和安全性。方法：该观察性单中心研究收集了2023年2月至2024年4月的数据。结果：利特莫韦组（n=20）和对照组（n=32） HSCT术后CMV dna血症的累积发生率分别为44.4%和66.3%。值得注意的是，与对照组相比，letermovir组临床显著CMV感染（csCMVi）的累积发生率显著降低（11.0% vs 41.3%, p=0.021）。在诊断为II-IV级急性移植物抗宿主病（aGVHD）的患者中，利特莫韦组出现CMV dna血症的个体比例明显低于对照组（20.0% vs 73.3%, p=0.013）。letermovir组常见不良事件为aGVHD（60.0%）、腹泻（25.0%）和恶心（15.0%）。仅有1例患者报告白细胞减少，不需要调整利特莫韦的剂量。结论：在这项单中心真实世界的研究中，letermovir在接受HSCT的青少年患者中显示出良好的CMV预防疗效和安全性。然而，需要进一步的前瞻性多中心研究来验证我们在青少年患者中的结论。
Real-world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation: a single center observational study.
Objectives: To compare the efficacy and safety of letermovir and ganciclovir for cytomegalovirus (CMV) prophylaxis in adolescent patients (aged 14-17 years) undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT).
Methods: This observational and single-center study collected data from February 2023 and April 2024.
Results: The cumulative incidence of CMV DNAemia following HSCT was 44.4% in the letermovir group (n=20) and 66.3% in the control group (n=32) receiving ganciclovir. Notably, the cumulative incidence of clinically significant CMV infection (csCMVi) was significantly reduced in the letermovir group compared with control patients (11.0% vs 41.3%, p=0.021). Among patients diagnosed with grades II-IV acute graft-versus-host disease (aGVHD), a significantly lower proportion of individuals in the letermovir group presented CMV DNAemia than in the control group (20.0% vs 73.3%, p=0.013). The common adverse events observed in the letermovir group were aGVHD (60.0%), diarrhea (25.0%), and nausea (15.0%). Leukopenia was reported in only one patient, and did not necessitate an adjustment of letermovir dosage.
Conclusions: In this single-center real-world study, letermovir exhibited a favourable efficacy and safety profile for CMV prophylaxis in adolescent patients undergoing HSCT. However, further prospective multi-center studies are warranted to validate our conclusion in adolescent patients.
期刊介绍：
Frontiers in Cellular and Infection Microbiology is a leading specialty journal, publishing rigorously peer-reviewed research across all pathogenic microorganisms and their interaction with their hosts. Chief Editor Yousef Abu Kwaik, University of Louisville is supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Cellular and Infection Microbiology includes research on bacteria, fungi, parasites, viruses, endosymbionts, prions and all microbial pathogens as well as the microbiota and its effect on health and disease in various hosts. The research approaches include molecular microbiology, cellular microbiology, gene regulation, proteomics, signal transduction, pathogenic evolution, genomics, structural biology, and virulence factors as well as model hosts. Areas of research to counteract infectious agents by the host include the host innate and adaptive immune responses as well as metabolic restrictions to various pathogenic microorganisms, vaccine design and development against various pathogenic microorganisms, and the mechanisms of antibiotic resistance and its countermeasures.
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