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

Freyer, Craig W.; Carulli, Alison; Gier, Shannon; Ganetsky, Alex; Timlin, Colleen; Schuster, Mindy G.; Babushok, Daria V.; Frey, Noelle V.; Gill, Saar; Hexner, Elizabeth O.; Luger, Selina M.; Mangan, James K.; Martin, Mary Ellen; McCurdy, Shannon R.; Perl, Alexander E.; Porter, David; Pratz, Keith W.; Smith, Jacqueline; Stadtmauer, Edward A.; Loren, Alison W.

doi:10.1080/10428194.2022.2042686

Cited by 5 publications

(2 citation statements)

References 35 publications

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“…Four retrospective studies 22 , 38 , 46 , 47 including 206 patients reported the CMV activation at 200 days after HSCT. The incidence of CMV activation at 200 days after allo-HSCT was 49% (95% CI, 32%–67%, Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Letermovir is a 3,4-dihydro-quinazoline-4-yl-acetic acid derivative that inhibits viral terminase complex inhibitor 18 , 19 Several studies observe that letermovir can prevent CMV activation after allo-HSCT. 20 – 22 However, most of them were retrospective studies and the efficacy of CMV prophylaxis was inconsistent among these studies.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of letermovir prophylaxis for cytomegalovirus infection after hematopoietic stem cell transplantation

Li,

Zhang,

Shen

et al. 2024

Blood Science

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Letermovir is a specific inhibitor of cytomegalovirus (CMV) terminase complex. Several studies have reported that letermovir can effectively prevent CMV activation after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We aimed to identify the efficacy and safety of letermovir prophylaxis for CMV infection after allo-HSCT with a systemic review and meta-analysis. A literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. PubMed and Embase databases were searched. A total of 28 studies were included. The incidence of CMV activation at 14 weeks after HSCT was 0.10 (95% confidence interval [CI], 0.06–0.18), which was 0.10 (95% CI, 0.04–0.21) and 0% in adult and children (2 studies were included and both of them were 0%). In addition, the incidence of CMV activation at 14 weeks after allo-HSCT was 0.11 (95% CI, 0.06–0.21) and 0.07 (only 1 study included), respectively, in retrospective and prospective studies. The incidence of CMV activation at 100 and 200 days after HSCT was 0.23 (95% CI, 0.16–0.33) and 0.49 (95% CI, 0.32–0.67), respectively. The incidence of CMV disease at 14 weeks and at 6 months after HSCT was 0.01 (95% CI, 0.01–0.02) and 0.03 (95% CI, 0.01–0.09), respectively. Thus, our systemic review and meta-analysis suggested that letermovir prophylaxis was safe and effective for CMV activation after allo-HSCT.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of letermovir prophylaxis for cytomegalovirus infection after hematopoietic stem cell transplantation

Li,

Zhang,

Shen

et al. 2024

Blood Science

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Long‐term outcome of 2‐year survivors after allogeneic hematopoietic cell transplantation for acute leukemia

Larue,

Labopin,

Schroeder

et al. 2024

HemaSphere

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Information on late complications in patients with acute leukemia who have undergone allogeneic hematopoietic cell transplantation (HCT) is limited. We performed a left‐truncated analysis of long‐term survival in patients with acute leukemia who were alive and disease‐free 2 years after HCT. We included 2701 patients with acute lymphoblastic leukemia (ALL) and 9027 patients with acute myeloid leukemia (AML) who underwent HCT between 2005 and 2012. The 10‐year overall survival (OS) rate was 81.3% for ALL and 76.2% for AML, with the main causes of late mortality being relapse (ALL‐33.9%, AML‐44.9%) and chronic graft‐versus‐host disease (ALL‐29%, AML‐18%). At 10 years, HCT‐related mortality was 16.8% and 20.4%, respectively. Older age and unrelated donor transplantation were associated with a worse prognosis for both types of leukemia. In addition, transplantation in the second or third complete remission and peripheral blood HSC for ALL are associated with worse outcomes. Similarly, adverse cytogenetics, female donor to male patient combination, and reduced intensity conditioning in AML contribute to poor prognosis. We conclude that 2‐year survival in remission after HCT for acute leukemia is encouraging, with OS of nearly 80% at 10 years. However, the long‐term mortality risk of HCT survivors remains significantly higher than that of the age‐matched general population. These findings underscore the importance of tailoring transplantation strategies to improve long‐term outcomes in patients with acute leukemia undergoing HCT.

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Outcomes of allogeneic hematopoietic cell transplantation under letermovir prophylaxis for cytomegalovirus infection

Takenaka,

Fuji,

Matsukawa

et al. 2023

Ann Hematol

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

Cited by 5 publications

References 35 publications

Efficacy and safety of letermovir prophylaxis for cytomegalovirus infection after hematopoietic stem cell transplantation

Efficacy and safety of letermovir prophylaxis for cytomegalovirus infection after hematopoietic stem cell transplantation

Long‐term outcome of 2‐year survivors after allogeneic hematopoietic cell transplantation for acute leukemia

Outcomes of allogeneic hematopoietic cell transplantation under letermovir prophylaxis for cytomegalovirus infection

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