Efficacy of prophylactic letermovir for cytomegalovirus reactivation in hematopoietic cell transplantation: a multicenter real-world data

Yasuo Mori, Fumiaki Jinnouchi, Katsuto Takenaka, Takatoshi Aoki, Takuro Kuriyama, Masanori Kadowaki, Jun Odawara, Toshiyuki Ueno, Kentaro Kohno, Takuya Harada, Goichi Yoshimoto, Ken Takase, Hideho Henzan, Koji Kato, Yoshikiyo Ito, Tomohiko Kamimura, Yuju Ohno, Ryosuke Ogawa, Tetsuya Eto, Koji NagafujiKoichi Akashi, Toshihiro Miyamoto

Research output: Contribution to journalArticlepeer-review

Abstract

A novel anti-cytomegalovirus (CMV) agent, letermovir (LMV), could reportedly improve the outcomes of allogeneic hematopoietic cell transplantation (allo-HCT) recipients because of its high potential to prevent CMV reactivation. Therefore, 685 Japanese allo-HCT recipients, of whom ~80% had a high risk of CMV reactivation, were retrospectively analyzed to assess the impacts of prophylactic LMV on the incidence of clinically significant CMV (csCMV) infection as well as their transplant outcome. By comparing 114 patients who received LMV prophylaxis for a median 92 days to 571 patients without prophylaxis, we observed that prophylactic LMV could significantly (1) reduce the 180-day cumulative incidence of csCMV infection (44.7 vs. 72.4%, p < 0.001), (2) delay the median time until initiation of CMV antigenemia-guided preemptive therapy (90 vs. 36 days, p < 0.001), (3) shorten the duration of anti-CMV preemptive treatment (21 vs. 25 days, p = 0.006), and (4) improve the overall survival rate at 180 days after transplant (80.4 vs. 73.0%, p = 0.033) with a trend of lower non-relapse mortality (8.9 vs. 14.9%, p = 0.052). Our findings demonstrate that prophylactic LMV treatment is highly effective in preventing the development of csCMV infection and ultimately reduces transplant-related mortality.

Original languageEnglish
JournalBone Marrow Transplantation
DOIs
Publication statusAccepted/In press - 2020

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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