UPDATE ON CYTOMEGALOVIRUS INFECTION MANAGEMENT IN ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANT RECIPIENTS.

作者：José Luís Piñana, Estela Giménez, Lourdes Vázquez, María Ángeles Marcos, Manuel Guerreiro, Rafael F. Duarte, Ariadna Pérez, Carlos de Miguel, Ildefonso Espigado, Marta González‐Vicent, María Suárez‐Lledó, Irene García‐Cadenas, Rodrigo Martino, Ángel Cedillo, Monserrat Rovira, Rafael de la Cámara, David Navarro, Carlos Solano · 发表于：Mediterranean Journal of Hematology and Infectious Diseases · 年份：2024 · DOI：10.4084/mjhid.2024.065 · 被引用次数：11 · 研究领域：Cytomegalovirus and herpesvirus research、Hematopoietic Stem Cell Transplantation、Neutropenia and Cancer Infections

Background: Cytomegalovirus (CMV) infection is a common complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT) and in patients receiving novel hematological therapies. Its impact on morbidity and mortality necessitates effective management strategies. Despite recent advances in diagnostics and treatment, unresolved questions persist regarding monitoring and treatment, prompting the need for updated recommendations. Methods: A consensus was reached among a panel of experts selected for their expertise in CMV research and clinical practice. Key clinical areas and questions were identified based on previous surveys and literature reviews. Recommendations were formulated through consensus and graded using established guidelines. Results: Recommendations were provided for virological monitoring, including the timing and frequency of CMV DNAemia surveillance, especially during letermovir (LMV) prophylaxis. We evaluated the role of CMV DNA load quantification in diagnosing CMV disease, particularly pneumonia and gastrointestinal involvement, along with the utility of specific CMV immune monitoring in identifying at-risk patients. Strategies for tailoring LMV prophylaxis, managing breakthrough DNAemia, and implementing secondary prophylaxis in refractory cases were outlined. Additionally, criteria for initiating early antiviral treatment based on viral load dynamics were discussed. Conclusion: The consensus provides updated recommendations for managing ...