Clinical “real-world” experience with letermovir for prevention of cytomegalovirus infection in allogeneic hematopoietic cell transplant recipients

Anthony Anderson, Mohammed Raja, Neisy Vazquez, Michele Morris, Krishna Komanduri, Jose Camargo

Research output: Contribution to journalArticle

Abstract

Background: Letermovir was approved in 2017 for prevention of cytomegalovirus (CMV) infection in seropositive (R+) allogeneic hematopoietic cell transplantation (HCT) patients. Post-marketing data with this new agent are scarce. Methods: We compared the incidence of both CMV reactivation (any viremia) and clinically significant CMV infection (CS-CMVi; CMV DNAemia leading to preemptive treatment or presence of CMV tissue invasive disease) at days +100 and +200 post-HCT in 25 adult allogeneic HCT patients who received letermovir prophylaxis (until day 100) and a historical control group of 106 CMV R+ allogeneic HCT recipients who underwent CMV preemptive therapy. Results: CMV reactivation within 100 days post-HCT was lower in the letermovir group vs control group (20% vs 72% respectively, P <.001). The 100-day cumulative incidence of CS-CMVi was significantly lower in the letermovir group vs control group (4% vs 59% respectively, P <.001). Significantly reduced incidence of CMV reactivation and CS-CMVi was also observed at 200 days in the letermovir group. No difference in mortality was observed between the two groups. Conclusion: This study confirms the efficacy of letermovir in preventing CMV reactivation in CMV R+ allogeneic HCT recipients in first 100 days post-HCT and suggests sustained efficacy after discontinuation of prophylaxis.

Original languageEnglish (US)
Article numbere13866
JournalClinical Transplantation
Volume34
Issue number7
DOIs
StatePublished - Jul 1 2020

Keywords

  • antibiotic prophylaxis
  • antibiotic: antiviral
  • infection and infectious agents
  • viral: Cytomegalovirus (CMV)

ASJC Scopus subject areas

  • Transplantation

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