Kilgore Jacob T, Becken Bradford, Varga Matthew G, Parikh Suhag, Prasad Vinod, Lugo Debra, Chang Yeh-Chung
Division of Pediatric Infectious Diseases, Duke University, Durham, North Carolina.
Department of Epidemiology, Gillings School of Global Public Health and the Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
J Pediatric Infect Dis Soc. 2020 Sep 17;9(4):486-489. doi: 10.1093/jpids/piz050.
We present here the first published use of letermovir for the treatment of resistant cytomegalovirus (CMV) in a pediatric patient. A 14-year-old girl underwent a double unrelated umbilical cord blood transplantation to treat her sickle cell disease (hemoglobin SS) and developed ganciclovir-resistant CMV DNAemia with end-organ involvement that was treated successfully with a combination of foscarnet and letermovir. After she was transitioned to letermovir monotherapy for secondary prophylaxis, she developed recurrent DNAemia with laboratory-confirmed ganciclovir, foscarnet, and letermovir resistance.
我们在此展示了首次发表的来特莫韦用于治疗儿科患者耐药巨细胞病毒（CMV）的案例。一名14岁女孩接受了两次无关供者脐血移植以治疗其镰状细胞病（血红蛋白SS型），并出现了对更昔洛韦耐药的CMV血症且伴有终末器官受累，通过膦甲酸钠和来特莫韦联合治疗成功治愈。在她转为接受来特莫韦单药进行二级预防后，又出现了复发性血症，实验室确认对更昔洛韦、膦甲酸钠和来特莫韦耐药。
