Cytomegalovirus Infection

Zaia, John A.

doi:10.1002/9781118416426.ch87

Cited by 4 publications

(3 citation statements)

References 87 publications

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“…There is sparse literature about post-aHSCT CMV reactivation rates in India, and it is estimated at between 10% and 39% [6,11,12]. The reactivation rates post-HIT seem to be more than umbilical cord transplants [2,3]. Unavailability of matched unrelated donors for the Indian population and cost constraints are making HITs more popular.…”

Section: Discussionmentioning

confidence: 99%

Use of Leflunomide for Treatment of Cytomegalovirus Infection in Recipients of Allogeneic Stem Cell Transplant

Gokarn

Toshniwal

Pathak

et al. 2019

Biology of Blood and Marrow Transplantation

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Cytomegalovirus (CMV) reactivations are common after allogeneic stem cell transplants, and pre-emptive therapy has been found to be effective. However, in India, treatment options are limited because of high cost and toxicity of ganciclovir and unavailability of cidofovir and foscarnet. Leflunomide is a cheap and easily available anti-rheumatoid arthritis drug that has been shown to have anti-CMV properties both in vitro and in vivo. It also has been used effectively for CMV reactivation after renal transplants. In this retrospective analysis, we analyzed 70 allogeneic stem cell transplants that were conducted between April 2015 and February 2017. There were 49 episodes of CMV reactivations in 43 patients in this period. Leflunomide was used in 24 episodes. It was effective in CMV clearance in 9 of the 24 episodes (38%). When the CMV copy number was <2 £ 10 3 copies/mL, leflunomide was effective in 9 of 17 (53%) episodes, but when the copy number was >2 £ 10 3 , leflunomide was ineffective in all of the 7 episodes. This difference was statistically significant (P= .022 by Fisher exact test), suggesting that leflunomide may be more effective in clearance of CMV when copy numbers are low.

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Section: Discussionmentioning

confidence: 99%

Use of Leflunomide for Treatment of Cytomegalovirus Infection in Recipients of Allogeneic Stem Cell Transplant

Gokarn

Toshniwal

Pathak

et al. 2019

Biology of Blood and Marrow Transplantation

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“…Ganciclovir (5 mg·kg -1 ) was administered intravenously twice daily for CMV prophylaxis from days –9 to –2. However, considering the side effects of ganciclovir prophylaxis that may negatively impact engraftment, we used acyclovir after donor stem cell infusion instead of ganciclovir ( Zaia, 2016 ). Acyclovir (200–400 mg) was orally administered against the herpes virus.…”

Section: Methodsmentioning

confidence: 99%

A Predicted Model for Refractory/Recurrent Cytomegalovirus Infection in Acute Leukemia Patients After Haploidentical Hematopoietic Stem Cell Transplantation

Shen

Hong

Wang

et al. 2022

Front. Cell. Infect. Microbiol.

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ObjectiveWe aimed to establish a model that can predict refractory/recurrent cytomegalovirus (CMV) infection after haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT).MethodsConsecutive acute leukemia patients receiving HID HSCT were enrolled (n = 289). We randomly selected 60% of the entire population (n = 170) as the training cohort, and the remaining 40% comprised the validation cohort (n = 119). Patients were treated according to the protocol registered at https://clinicaltrials.gov (NCT03756675).ResultsThe model was as follows: Y = 0.0322 × (age) – 0.0696 × (gender) + 0.5492 × (underlying disease) + 0.0963 × (the cumulative dose of prednisone during pre-engraftment phase) – 0.0771 × (CD34+ cell counts in graft) – 1.2926. The threshold of probability was 0.5243, which helped to separate patients into high- and low-risk groups. In the low- and high-risk groups, the 100-day cumulative incidence of refractory/recurrent CMV was 42.0% [95% confidence interval (CI), 34.7%–49.4%] vs. 63.7% (95% CI, 54.8%–72.6%) (P < 0.001) for total patients and was 50.5% (95% confidence interval (CI), 40.9%–60.1%) vs. 71.0% (95% CI, 59.5%–82.4%) (P = 0.024) for those with acute graft-versus-host disease. It could also predict posttransplant mortality and survival.ConclusionWe established a comprehensive model that could predict the refractory/recurrent CMV infection after HID HSCT.Clinical Trial Registrationhttps://clinicaltrials.gov, identifier NCT03756675.

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“…Futuramente, a reconstituição imunológica especifica do CMV, através do uso de imunoterapia, células ou vacina ativa, pode tornar-se, junto com agentes anti-virais menos tóxicos, um método mais efetivo para prevenir doença pelo CMV nesta população (103) .…”

Section: Transplante De Células Tronco Alogênicounclassified

O transplante de células tronco hematopoéticas alogênico e autogênico na leucemia mielóide aguda em primeira remissão completa: análise de 62 pacientes

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Cytomegalovirus Infection

Cited by 4 publications

References 87 publications

Use of Leflunomide for Treatment of Cytomegalovirus Infection in Recipients of Allogeneic Stem Cell Transplant

Use of Leflunomide for Treatment of Cytomegalovirus Infection in Recipients of Allogeneic Stem Cell Transplant

A Predicted Model for Refractory/Recurrent Cytomegalovirus Infection in Acute Leukemia Patients After Haploidentical Hematopoietic Stem Cell Transplantation

O transplante de células tronco hematopoéticas alogênico e autogênico na leucemia mielóide aguda em primeira remissão completa: análise de 62 pacientes

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