TY - JOUR
T1 - Efficacy of prophylactic letermovir for cytomegalovirus reactivation in hematopoietic cell transplantation
T2 - a multicenter real-world data
AU - Mori, Yasuo
AU - Jinnouchi, Fumiaki
AU - Takenaka, Katsuto
AU - Aoki, Takatoshi
AU - Kuriyama, Takuro
AU - Kadowaki, Masanori
AU - Odawara, Jun
AU - Ueno, Toshiyuki
AU - Kohno, Kentaro
AU - Harada, Takuya
AU - Yoshimoto, Goichi
AU - Takase, Ken
AU - Henzan, Hideho
AU - Kato, Koji
AU - Ito, Yoshikiyo
AU - Kamimura, Tomohiko
AU - Ohno, Yuju
AU - Ogawa, Ryosuke
AU - Eto, Tetsuya
AU - Nagafuji, Koji
AU - Akashi, Koichi
AU - Miyamoto, Toshihiro
N1 - Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2021/4
Y1 - 2021/4
N2 - 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.
AB - 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.
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U2 - 10.1038/s41409-020-01082-z
DO - 10.1038/s41409-020-01082-z
M3 - Article
C2 - 33139867
AN - SCOPUS:85094951811
VL - 56
SP - 853
EP - 862
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
SN - 0268-3369
IS - 4
ER -