Pharmacy, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Blood and Marrow Transplantation Program, Hospital of the University of Pennsylvania, Abramson Cancer Center and the Division of Hematology and Oncology, Philadelphia, PA, USA.
Leuk Lymphoma. 2022 Aug;63(8):1925-1933. doi: 10.1080/10428194.2022.2042686. Epub 2022 Feb 20.
Patients undergoing haploidentical or mismatched unrelated donor (haplo/MMUD) allogeneic hematopoietic cell transplantation (alloHCT) receiving post-transplant cyclophosphamide (PTCy) are at high risk of cytomegalovirus (CMV) infection. Experience with letermovir (LET) in this population is limited. This single center retrospective cohort study compared CMV and transplant outcomes between LET and a historical control with high-dose valacyclovir (HDV) prophylaxis in adults undergoing haplo/MMUD alloHCT. Thirty-eight CMV seropositive patients were included, 19 in each arm. LET reduced the incidence of CMV infection (5% vs. 53%, RR 0.01, 95% CI 0.014-0.71, = .001) and need for CMV treatment by day +100 (5% vs. 37%, RR 0.14, 95% CI 0.18-0.99, = .017) compared to HDV. Median CMV event-free-survival was improved with LET (not reached vs. 80 days, HR 0.114, 95% CI 0.07-0.61, = .004). These data support the efficacy of LET in alternative donor transplants.
接受移植后环磷酰胺（PTCy）治疗的单倍体或不合配非亲缘供体（haplo/MMUD）异基因造血细胞移植（alloHCT）的患者存在巨细胞病毒（CMV）感染的高风险。在该人群中使用来特莫韦（LET）的经验有限。这项单中心回顾性队列研究比较了 LET 和高剂量伐昔洛韦（HDV）预防方案在接受 haplo/MMUD alloHCT 的成人中的 CMV 和移植结局。共纳入 38 例 CMV 血清阳性患者，每组 19 例。与 HDV 相比，LET 降低了 CMV 感染的发生率（5% vs. 53%，RR 0.01，95%CI 0.014-0.71， = .001）和第 100 天（5% vs. 37%，RR 0.14，95%CI 0.18-0.99， = .017）需要 CMV 治疗的需求。与 HDV 相比，LET 改善了 CMV 无事件生存（未达到 vs. 80 天，HR 0.114，95%CI 0.07-0.61， = .004）。这些数据支持 LET 在替代供体移植中的疗效。
