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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
Affiliations- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznań, Poland
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
- Department of Hematology, Institute od Hematology and Transfusion Medicine in Warsaw, Warszawa, Poland
- Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, Wrocław, Poland
- Department of Hematology, Collegium Medicum, Jagiellonian University, Kraków, Poland
- Department of Hematology and Transplantology, Lower Silesian Oncology Center, Wrocław, Poland
- Department of Hematology, Blood Neoplasm and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland
- Department of Hematology, Medical University in Lodz, Łódż, Poland
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Abstract
Introduction: Letermovir (LMV) is a new, cytomegalovirus (CMV)-specific, antiviral drug, approved in 2018 for CMV prophylaxis in patients after allogeneic hematopoietic transplantation. The introduction of letermovir prophylaxis has changed the management of CMV infection: it has reduced the incidence of CMV infections and CMV-related complications, and also improved the overall survival in CMV seropositive patients. However, until recently, due to its high treatment cost, prophylaxis with letermovir has not beeen a standard of care in Poland. Material and methods: To confirm the effectiveness and safety of letermovir prophylaxis, we collected real-life data from eight Polish transplant centers, in which a total of 53 patients were treated with letermovir, including off-label use. Results: LMV is characterized by low toxicity and good tolerability. There were no reports of special adverse events caused by LMV. Conclusions: Our experiences confirm the effectiveness and safety of letermovir prophylaxis, and suggest that this prophylaxis should be started as soon as possible after the infusion of stem cells, preferably no later than day 14. Moreover, our findings indicate that some patients could benefit from extended letermovir prophylaxis beyond 100 days after transplant.
Abstract
Introduction: Letermovir (LMV) is a new, cytomegalovirus (CMV)-specific, antiviral drug, approved in 2018 for CMV prophylaxis in patients after allogeneic hematopoietic transplantation. The introduction of letermovir prophylaxis has changed the management of CMV infection: it has reduced the incidence of CMV infections and CMV-related complications, and also improved the overall survival in CMV seropositive patients. However, until recently, due to its high treatment cost, prophylaxis with letermovir has not beeen a standard of care in Poland. Material and methods: To confirm the effectiveness and safety of letermovir prophylaxis, we collected real-life data from eight Polish transplant centers, in which a total of 53 patients were treated with letermovir, including off-label use. Results: LMV is characterized by low toxicity and good tolerability. There were no reports of special adverse events caused by LMV. Conclusions: Our experiences confirm the effectiveness and safety of letermovir prophylaxis, and suggest that this prophylaxis should be started as soon as possible after the infusion of stem cells, preferably no later than day 14. Moreover, our findings indicate that some patients could benefit from extended letermovir prophylaxis beyond 100 days after transplant.
Keywords
cytomegalovirus infection, allogeneic hematopoietic stem cell transplantation, letermovir, antiviral prophylaxis
About this articleTitle
Real-life experiences of letermovir prophylaxis for cytomegalovirus infection in patients after hematopoietic stem cell transplantation: Polish Acute Leukemia Group (PALG) analysis
Journal
Issue
Article type
Original research article
Pages
350-354
Published online
2022-10-02
Page views
1504
Article views/downloads
130
DOI
10.5603/AHP.a2022.2047
Bibliographic record
Acta Haematol Pol 2022;53(5):350-354.
Keywords
cytomegalovirus infection
allogeneic hematopoietic stem cell transplantation
letermovir
antiviral prophylaxis
Authors
Anna Łojko
Jan Styczyński
Barbara Nasiłowska-Adamska
Joanna Mańko
Krzysztof Kałwak
Patrycja Mensah-Glanowska
Jarosław Dybko
Maciej Majcherek
Anna Czyż
Agnieszka Pluta
Lidia Gil
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