Current and Future Options for Cytomegalovirus Reactivation in Hematopoietic Cell Transplantation Patients

Abstract

Report from the 43rd Annual Meeting of the European Society for Blood & Marrow Transplantation 2017, 26-29 March 2017, Marseille, France Cytomegalovirus (CMV) reactivation is a potentially life-threatening complication in immunocompromised recipients of hematopoietic cell transplantation (HCT). Its management was therefore a key topic for over 5000 delegates from 85 countries attending the 43rd Annual Meeting of the European Society for Blood & Marrow Transplantation 2017. The currently available anti-CMV armamentarium is seldom used to prevent CMV reactivation due to the associated myelosuppression and renal toxicity. Following HCT, CMV reactivation is generally managed pre-emptively using sensitive assays for early detection of viral DNA (and to a lesser extent antigenemia) and, where necessary, treatment with antiviral drugs with the aim of preventing CMV disease. However, any degree of CMV reactivation increases the risk of mortality, and novel antiviral therapies may offer the possibility of prophylaxis to prevent CMV reactivation and improve survival after HCT.

Use of low cell dose for unmanipulated donor lymphocyte for management of cytomegalovirus infection: A single‐center experience

“…CMV disease is still one of the major complications post-HSCT, with a reactivation rate of 30%-70%. [11][12][13] The spectrum of CMV infection is quite broad, from CMV reactivation without any organ involve- Alternatively, techniques for the isolation of virus-specific T-cells have improved in the last two decades. [4][5][6]14 Virus-specific T-cells can be generated by ex vivo expansion of donor peripheral blood mononuclear cells.…”

“…CMV disease is still one of the major complications post‐HSCT, with a reactivation rate of 30%‐70% 11‐13 . The spectrum of CMV infection is quite broad, from CMV reactivation without any organ involvement, presenting mainly as an asymptomatic viremia, to CMV end‐organ diseases.…”

Gastric Ulcers with Cytomegalovirus Infection in an Immunocompetent Patient

“…CMV infection has been known to commonly occur in immunodeficiency patients, such as those with HIV infection, who underwent solid organ or stem cell transplantation, and those undergoing chemo-or radiotherapy. [1][2][3] However, in the last decades, CMV disease in immunocompetent patients has been increasing, involving the upper gastrointestinal tract. 4 The clinical presentation of upper gastrointestinal CMV disease widely varies and depends on its location or severity in immunocompetent patients.…”

“…1 However, it is usually asymptomatic, but can cause symptoms like mononucleosis syndrome, in immunocompetent patients. 2 Generally, CMV infections involve many organs, such as the lungs, liver, central nervous system, and gastrointestinal tract, mostly common in the stomach and colon. 1 Gastrointestinal CMV infection is rare in hosts with normal immune system.…”

Selective 4-Thiouracil Labeling of RNA Transcripts within Latently Infected Cells after Infection with Human Cytomegalovirus Expressing Functional Uracil Phosphoribosyltransferase

“…During conditions of immunological stress coupled with cytokine stimulation, the HCMV lytic cycle initiates and virus production ensues (14). While current antiviral strategies against HCMV exist, they only limit viral DNA replication and packaging of viral progeny, both late stages of the viral lytic cycle (15).…”