Letermovir vs. high-dose valacyclovir for cytomegalovirus prophylaxis following haploidentical or mismatched unrelated donor allogeneic hematopoietic cell transplantation receiving post-transplant cyclophosphamide

被引：6
作者：
Freyer, Craig W. [1 ]
Carulli, Alison [1 ]
Gier, Shannon [2 ,3 ]
Ganetsky, Alex [1 ]
Timlin, Colleen [1 ]
Schuster, Mindy [4 ]
Babushok, Daria [2 ,3 ]
Frey, Noelle, V [2 ,3 ]
Gill, Saar, I [2 ,3 ]
Hexner, Elizabeth O. [2 ,3 ]
Luger, Selina M. [2 ,3 ]
Mangan, James K. [2 ,3 ]
Martin, Mary Ellen [2 ,3 ]
McCurdy, Shannon R. [2 ,3 ]
Perl, Alexander E. [2 ,3 ]
Porter, David L. [2 ,3 ]
Pratz, Keith [2 ,3 ]
Smith, Jacqueline [2 ,3 ]
Stadtmauer, Edward A. [2 ,3 ]
Loren, Alison W. [2 ,3 ]
机构：
[1] Hosp Univ Penn, Pharm, Philadelphia, PA 19104 USA
[2] Hosp Univ Penn, Abramson Canc Ctr, Blood & Marrow Transplantat Program, Philadelphia, PA 19104 USA
[3] Hosp Univ Penn, Div Hematol & Oncol, Blood & Marrow Transplantat Program, Philadelphia, PA 19104 USA
[4] Hosp Univ Penn, Infect Dis Div, Philadelphia, PA 19104 USA
来源：
LEUKEMIA & LYMPHOMA | 2022年 / 63卷 / 08期
关键词：
Letermovir; valacyclovir; cytomegalovirus; haploidentical; post-transplant cyclophosphamide; prophylaxis; VERSUS-HOST-DISEASE; BONE-MARROW-TRANSPLANTATION; UMBILICAL-CORD BLOOD; GANCICLOVIR PROPHYLAXIS; CLINICAL-TRIAL; CMV DISEASE; PREVENTION; REACTIVATION; INFECTION; MULTICENTER;
D O I：
10.1080/10428194.2022.2042686
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Patients undergoing haploidentical or mismatched unrelated donor (haplo/MMUD) allogeneic hematopoietic cell transplantation (alloHCT) receiving post-transplant cyclophosphamide (PTCy) are at high risk of cytomegalovirus (CMV) infection. Experience with letermovir (LET) in this population is limited. This single center retrospective cohort study compared CMV and transplant outcomes between LET and a historical control with high-dose valacyclovir (HDV) prophylaxis in adults undergoing haplo/MMUD alloHCT. Thirty-eight CMV seropositive patients were included, 19 in each arm. LET reduced the incidence of CMV infection (5% vs. 53%, RR 0.01, 95% CI 0.014-0.71, p = .001) and need for CMV treatment by day +100 (5% vs. 37%, RR 0.14, 95% CI 0.18-0.99, p = .017) compared to HDV. Median CMV event-free-survival was improved with LET (not reached vs. 80 days, HR 0.114, 95% CI 0.07-0.61, p = .004). These data support the efficacy of LET in alternative donor transplants.
引用
收藏
页码：1925 / 1933
页数：9
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