Cytomegalovirus immune globulin and seronegative blood products to prevent primary cytomegalovirus infection after marrow transplantation. Whether it could be part of a strategy could be tested in randomized trials. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Although the direct effects of CMV (ie, CMV pneumonia) have been largely eliminated, several recent cohort studies show that CMV-seropositive transplant recipients and seronegative recipients of a positive graft appear to have a persistent mortality disadvantage when compared with seronegative recipients with a seronegative donor. McGlave PB, Shu XO, Wen W, et al. Despite the significant decline in the incidence of CMV disease among CMV seropositive HSCT recipients early after transplantation, several recent studies have indicated that a substantial mortality disadvantage still exists for the CMV-seropositive patient (Table 1). We evaluated the efficacy of letermovir as primary and secondary prophylaxis in 53 CMV‐seropositive hematopoietic stem cell transplant recipients. Dr Papanicolaou serves as a Consultant for Merck, Astellas, Chimerix, Clinigen, Ideogen, Shionogi, ADMA, and Amplyx. Patients treated with allogeneic hematopoietic cell transplantation (HCT) are at risk of cytomegalovirus (CMV) reactivation and disease, which results in increased morbidity and mortality.  |  In the current era of effective prophylactic and preemptive therapy, cytomegalovirus (CMV) is now a rare cause of early mortality after hematopoietic stem cell transplantation (HSCT). Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Clin Infect Dis 2020; 70:1525. Although universal antiviral prophylaxis against CMV improves outcomes in solid organ transplant recipients, da … Please enable it to take advantage of the complete set of features! Meijer also failed to find a difference in acute GVHD according to serostatus, but a significant increase in infectious mortality was detected among seropositive recipients of unrelated donor transplants.12  The putative immunomodulatory effects of CMV infection have long been recognized in the setting of solid organ transplantation and HIV/AIDS, and have recently been reviewed.15. Unfortunately, available anti-CMV agents, mainly viral polymerase inhibitors, have a substantial risk of myelosuppression and nephrotoxicity. A Randomized, Double-Blind, Placebo-Controlled Phase 3 Trial of Oral Brincidofovir for Cytomegalovirus Prophylaxis in Allogeneic Hematopoietic Cell Transplantation. Letermovir for the prevention of cytomegalovirus infection in adult cytomegalovirus-seropositive hematopoietic stem cell transplant recipients. Prepublished online as Blood First Edition Paper, November 26, 2003; DOI 10.1182/blood-2003-10-3616. The European Acyclovir for CMV Prophylaxis Study Group. Peggs KS, Verfuerth S, Pizzey A, et al. Castro-Malaspina H, Harris RE, Gajewski J, et al. Increased transplant-related morbidity and mortality in CMV-seropositive patients despite highly effective prevention of CMV disease after allogeneic T-cell-depleted stem cell transplantation. Letermovir, a viral terminase complex inhibitor, was approved by the FDA in November 2017 for CMV prophylaxis in adult CMV-seropositive recipients of an allogeneic hematopoietic stem cell transplant (HSCT). If only a CMV-seropositive donor is available for a CMV-seronegative patient, the risk of transmission of CMV by the stem cell product to the recipient is approximately 20% to 30%. eCollection 2020. Kollman C, Howe CW, Anasetti C, et al. The type of transplant also affects the CMV risk – lung, heart and multi-organ transplants carry the highest risk, kidney and stem cell transplants the lowest. Boeckh M, Gooley TA, Myerson D, Cunningham T, Schoch G, Bowden RA. doi: 10.1136/bmjopen-2019-034940. Trends in transplantation of hematopoietic stem cells from unrelated donors. Human cytomegalovirus seropositivity is associated with decreased survival in glioblastoma patients. He serves in a volunteer capacity as a member of the Board of Directors of American Society of Transplantation and Cellular Therapy (ASTCT) and Be the Match (National Marrow Donor Program, NMDP), as well as on the CIBMTR Advisory Committee and Cellular Immunotherapy Data Resource (CIDR) Oversight Committee. 2020 Apr 3:e13866. Reconciling these results is difficult, but of significant clinical importance. A novel nonnucleoside inhibitor specifically targets cytomegalovirus DNA maturation via the UL89 and UL56 gene products. Randomized multicenter trial of foscarnet versus ganciclovir for preemptive therapy of cytomegalovirus infection after allogeneic stem cell transplantation. However, the ultimate goal of completely eliminating the impact of CMV on survival remains elusive. Major-histocompatibility-complex class I alleles and antigens in hematopoietic-cell transplantation. eCollection 2019. 2018 Oct;11(10):931-941. doi: 10.1080/17512433.2018.1500897. National marrow donor program HLA-matching guidelines for unrelated marrow transplants. Toxicity and efficacy of daily dapsone as Pneumocystis jiroveci prophylaxis after hematopoietic stem cell transplantation: a case-control study. COVID-19 is an emerging, rapidly evolving situation. Results were adjusted for time periods in both studies,2,3  however, it is possible that important differences in posttransplant prevention strategies and supportive care were not accounted for. Get the latest research from NIH: https://www.nih.gov/coronavirus. 2020 May 7;135(19):1619-1629. doi: 10.1182/blood.2019000956.

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