Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33315, Taiwan.
Division of Nursing, Chang Gung Memorial Hospital, Taoyuan 33315, Taiwan.
Viruses. 2024 Aug 8;16(8):1268. doi: 10.3390/v16081268.
This systematic review discusses the use of prophylaxis to prevent cytomegalovirus (CMV) infection in recipients who have undergone hematopoietic cell transplantation. It highlights the need for new approaches to control and prevent CMV infection. The approval of the anti-CMV drug letermovir has made antiviral prophylaxis more popular. CMV-specific T cell-mediated immunity tests are effective in identifying patients who have undergone immune reconstitution and predicting disease progression. Maribavir (MBV) has been approved for the treatment of post-transplant CMV infection/disease in adolescents. Adoptive T-cell therapy and the PepVax CMV vaccine show promise in tackling refractory and resistant CMV. However, the effectiveness of PepVax in reducing CMV viremia/disease was not demonstrated in a phase II trial. Cell-mediated immunity assays are valuable for personalized management plans, but more interventional studies are needed. MBV and adoptive T-cell therapy are promising treatments, and trials for CMV vaccines are ongoing.
这篇系统综述讨论了在接受造血细胞移植的患者中使用预防措施来预防巨细胞病毒(CMV)感染。它强调了需要新的方法来控制和预防 CMV 感染。抗 CMV 药物来特莫韦的批准使得抗病毒预防更受欢迎。CMV 特异性 T 细胞介导的免疫试验可有效识别已进行免疫重建的患者,并预测疾病进展。马拉韦罗(MBV)已获准用于治疗青少年移植后 CMV 感染/疾病。过继性 T 细胞疗法和 PepVax CMV 疫苗在解决难治性和耐药性 CMV 方面显示出希望。然而,PepVax 在 II 期试验中并未显示出降低 CMV 病毒血症/疾病的有效性。细胞介导的免疫测定对个性化管理计划很有价值,但需要更多的干预性研究。MBV 和过继性 T 细胞疗法是有前途的治疗方法,CMV 疫苗的试验正在进行中。