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Erschienen in: International Journal of Hematology 3/2023

19.07.2023 | Original Article

Efficacy of letermovir in HLA-haploidentical hematopoietic transplantation with posttransplant cyclophosphamide

verfasst von: Daishi Nakagawa, Yoshimitsu Shimomura, Satoshi Mitsuyuki, Tomoyo Kubo, Masashi Nishikubo, Naoki Okada, Kimimori Kamijo, Ryusuke Yamamoto, Yuya Nagai, Nobuhiro Hiramoto, Satoshi Yoshioka, Noboru Yonetani, Takayuki Ishikawa

Erschienen in: International Journal of Hematology | Ausgabe 3/2023

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Abstract

Background

Cytomegalovirus reactivation (CMV-R) is a significant complication of allogeneic hematopoietic stem cell transplantation (allo-HCT), especially in human leukocyte antigen-haploidentical transplantation (haplo-HCT) with posttransplant cyclophosphamide (PTCy). Prophylactic letermovir (LTV) prevents CMV-R in patients undergoing allo-HCT. However, evidence regarding its use in haplo-HCTs with PTCy is limited. Therefore, we aimed to investigate the efficacy of prophylactic LTV in haplo-HCT with PTCy.

Methods

We retrospectively analyzed 52 patients seropositive for CMV who underwent haplo-HCT with PTCy at our institution between January 2015 and June 2021 and compared patients who received LTV prophylaxis (LTV group: n = 29) with those who did not receive prophylaxis for CMV (control group: n = 23). The primary endpoint was the 100-day cumulative CMV-R incidence. We used Gray's test and the Fine and Gray test to compare the two groups.

Results

The 100-day cumulative CMV-R incidence was lower in the LTV group than in the control group (17.2% vs 81.8%, p < 0.001). Multivariate analysis revealed that prophylactic LTV reduced the 100-day cumulative CMV-R incidence (hazard ratio: 0.17, 95% confidence interval: 0.06–0.44, p < 0.001).

Conclusions

Prophylactic LTV effectively prevents CMV-R in patients undergoing haplo-HCT for PTCy.
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Metadaten
Titel
Efficacy of letermovir in HLA-haploidentical hematopoietic transplantation with posttransplant cyclophosphamide
verfasst von
Daishi Nakagawa
Yoshimitsu Shimomura
Satoshi Mitsuyuki
Tomoyo Kubo
Masashi Nishikubo
Naoki Okada
Kimimori Kamijo
Ryusuke Yamamoto
Yuya Nagai
Nobuhiro Hiramoto
Satoshi Yoshioka
Noboru Yonetani
Takayuki Ishikawa
Publikationsdatum
19.07.2023
Verlag
Springer Nature Singapore
Erschienen in
International Journal of Hematology / Ausgabe 3/2023
Print ISSN: 0925-5710
Elektronische ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-023-03635-6

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