Optimal Strategy for CMV Prevention in HCT

CE / CME

Reducing the Burden of Cytomegalovirus in HCT: Optimal Strategy for Prevention

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurse Practitioners: 1.00 Nursing contact hours, includes 1.00 hour of pharmacotherapy credit

Released: July 21, 2023

Expiration: July 20, 2024

Activity

Progress
1
Course Completed

References

  1. Ariza-Heredia EJ, Nesher L, Chemaly RF. Cytomegalovirus diseases after hematopoietic stem cell transplantation: a mini-review. Cancer Lett. 2014;342:1-8.
  2. Cui J, Zhao K, Sun Y, et al. Diagnosis and treatment for the early stage of cytomegalovirus infection during hematopoietic stem cell transplantation. Front Immunol. 2022;13:971156.
  3. Fowler K, Mucha J, Neumann M, et al. A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development. BMC Public Health. 2022;22:1659.
  4. Chen K, Cheng MP, Hammond SP, Einsele H, Marty FM. Antiviral prophylaxis for cytomegalovirus infection in allogeneic hematopoietic cell transplantation. Blood Adv. 2018;2:2159-2175.
  5. Aldoss I, La Rosa C, Baden LR, et al. Poxvirus vectored cytomegalovirus vaccine to prevent cytomegalovirus viremia in transplant recipients: a phase 2, randomized clinical trial. Ann Intern Med. 2020;172:306-316.
  6. Einsele H, Ljungman P, Boeckh M. How I treat CMV reactivation after allogeneic hematopoietic stem cell transplantation. Blood. 2020;135:1619-1629.
  7. Hakki M, Aitken SL, Danziger-Isakov L, et al. American Society for Transplantation and Cellular Therapy series: #3-prevention of cytomegalovirus infection and disease after hematopoietic cell transplantation. Transplant Cell Ther. 2021;27:707-719.
  8. Green ML, Leisenring W, Xie H, et al. Cytomegalovirus viral load and mortality after haemopoietic stem cell transplantation in the era of pre-emptive therapy: a retrospective cohort study. Lancet Haematol. 2016;3:e119-127.
  9. Teira P, Battiwalla M, Ramanathan M, et al. Early cytomegalovirus reactivation remains associated with increased transplant-related mortality in the current era: a CIBMTR analysis. Blood. 2016;127:2427-2438.
  10. Haidar G, Boeckh M, Singh N. Cytomegalovirus infection in solid organ and hematopoietic cell transplantation: state of the evidence. J Infect Dis. 2020;221:S23-S31.
  11. Bulka CM, Bommarito PA, Aiello AE, Fry RC. Cytomegalovirus seroprevalence, recurrence, and antibody levels: Associations with cadmium and lead exposures in the general United States population. Environ Epidemiol. 2020;4:e100.
  12. Ljungman P, Brand R, Hoek J, et al. Donor cytomegalovirus status influences the outcome of allogeneic stem cell transplant: a study by the European group for blood and marrow transplantation. Clin Infect Dis. 2014;59:473-481.
  13. Zakhour J, Allaw F, Haddad SF, Kanj SS. The ten most common questions on cytomegalovirus infection in hematopoietic stem cell transplant patients. Clin Hematol Int. 2023;5:21-28.
  14. Ganciclovir [prescribing information]. Schaumberg, IL: Sagent Pharmaceuticals; 2020.
  15. Valganciclovir [prescribing information]. South San Francisco, CA: Genentech USA, Inc.; 2021.
  16. van der Heiden PL, Kalpoe JS, Barge RM, Willemze R, Kroes AC, Schippers EF. Oral valganciclovir as pre-emptive therapy has similar efficacy on cytomegalovirus DNA load reduction as intravenous ganciclovir in allogeneic stem cell transplantation recipients. Bone Marrow Transplant. 2006;37:693-698.
  17. Foscarnet [prescribing information]. Lake Forest, IL: Hospira, Inc; 2020.
  18. Jakharia N, Howard D, Riedel DJ. CMV infection in hematopoietic stem cell transplantation: prevention and treatment strategies. Curr Treat Options Infect Dis. 2021;13:123-140.
  19. Halpern-Cohen V, Blumberg EA. New perspectives on antimicrobial agents: maribavir. Antimicrob Agents Chemother. 2022;66:e0240521.
  20. Stycynski J. Prophylaxis vs preemptive therapy for prevention of CMV infection: new insight on prophylactic strategy after allogeneic hematopoietic cell transplantation. Acta Haematol Polonica. 2020;51:17.
  21. Saullo JL, Miller RA. Cytomegalovirus therapy: role of letermovir in prophylaxis and treatment in transplant recipients. Annu Rev Med. 2023;74:89-105.
  22. Marty FM, Ljungman P, Chemaly RF, et al. Letermovir prophylaxis for cytomegalovirus in hematopoietic-cell transplantation. N Engl J Med. 2017;377:2433-2444.
  23. Ljungman P, Schmitt M, Marty FM, et al. A mortality analysis of letermovir prophylaxis for cytomegalovirus (CMV) in CMV-seropositive recipients of allogeneic hematopoietic cell transplantation. Clin Infect Dis. 2020;70:1525-1533.
  24. Vyas A, Raval AD, Kamat S, LaPlante K, Tang Y, Chemaly RF. Real-world outcomes associated with letermovir use for cytomegalovirus primary prophylaxis in allogeneic hematopoietic cell transplant recipients: a systematic review and meta-analysis of observational studies. Open Forum Infect Dis. 2023;10:ofac687.
  25. Sassine J, Khawaja F, Shigle TL, et al. Refractory and resistant cytomegalovirus after hematopoietic cell transplant in the letermovir primary prophylaxis era. Clin Infect Dis. 2021;73:1346-1354.
  26. Dadwal SS, Russo D, Stelljes M, et al. A phase 3 randomized, double-blind, placebo-controlled trial evaluating the safety and efficacy of letermovir prophylaxis when extended from 100 to 200 days post-transplant in cytomegalovirus-seropositive recipients of an allogeneic hematopoietic stem cell transplant. Presented at: ASTCT/CIBMTR World Congress, February 18, 2023. tandem.confex.com/tandem/2023/meetingapp.cgi/Paper/21616. Accessed July 13, 2023.
  27. Sourisseau M, Faure E, Behal H, et al. The promising efficacy of a risk-based letermovir use strategy in CMV-positive allogeneic hematopoietic cell recipients. Blood Adv. 2023;7:856-865.
  28. Korholz KF, Fuller MA, Hennies M, et al. Letermovir for prophylaxis and pre-emptive therapy of cytomegalovirus infection in paediatric allogeneic haematopoietic cell transplant patients. Paediatr Drugs. 2023;25:225-232.
  29. Groll AH, Schulte JH, Antmen AB, et al. Preliminary dosing for adolescent hematopoietic stem-cell transplant (HSCT) recipients based on pharmacokinetic (PK), safety, and efficacy data of letermovir (LET) for cytomegalovirus (CMV) prophylaxis. Open Forum Infect Dis. 2022;Supplement_2:ofac492.675.
  30. Letermovir [prescribing information]. Rahway, NJ: Merck & Co, Inc.; 2022.
  31. Winston DJ, Ho WG, Bartoni K, et al. Ganciclovir prophylaxis of cytomegalovirus infection and disease in allogeneic bone marrow transplant recipients. Results of a placebo-controlled, double-blind trial. Ann Intern Med. 1993;118:179-184.
  32. Goodrich JM, Bowden RA, Fisher L, Keller C, Schoch G, Meyers JD. Ganciclovir prophylaxis to prevent cytomegalovirus disease after allogeneic marrow transplant. Ann Intern Med. 1993;118:173-178.
  33. Boeckh M, Nichols WG, Chemaly RF, et al. Valganciclovir for the prevention of complications of late cytomegalovirus infection after allogeneic hematopoietic cell transplantation: a randomized trial. Ann Intern Med. 2015;162:1-10.
  34. Maertens J, Cordonnier C, Jaksch P, et al. Maribavir for preemptive treatment of cytomegalovirus reactivation. N Engl J Med. 2019;381:1136-1147.
  35. Maribavir [prescribing information]. Lexington, MA: Takeda Pharmaceuticals America, Inc.; 2023.
  36. National Comprehensive Cancer Network. Prevention and treatment of cancer-related infections. Version 3.2022. www.nccn.org.