Letermovir prophylaxis for cytomegalovirus is associated with risk of post-transplant lymphoproliferative disorders after haploidentical stem cell transplantation

作者：Xuying Pei, Qiang Huang, Ling-Jie Luo, Hai-Lu Sun, Jing Liu, Yuqian Sun, Xiao‐Dong Mo, Meng Lv, Dai-Hong Liu, Hongyan Ma, Yanwei Wu, Lan‐Ping Xu, Yu Wang, Xiaohui Zhang, Liang Chen, Xiao‐Jun Huang · 发表于：Haematologica · 年份：2024 · DOI：10.3324/haematol.2024.286265 · 被引用次数：12 · 研究领域：Cytomegalovirus and herpesvirus research、Parvovirus B19 Infection Studies、Polyomavirus and related diseases

Letermovir prophylaxis for cytomegalovirus is associated with risk of post-transplant lymphoproliferative disorders after haploidentical stem cell transplantationCytomegalovirus (CMV) and Epstein-Barr virus (EBV) emerge as the most frequently reactivated opportunistic viruses after haploidentical stem cell transplantation (haplo-SCT). [1][2]][3] As members of the family of herpesviruses, CMV and EBV are reported to be linked to causing clinical manifestations, resulting in co-infection rates ranging from 10% to 32.7%. 4,5dditionally, CMV treatment coincides with EBV reactivation, potentially affecting the progression of EBV reactivation and EBV-associated diseases. 6,7Letermovir prophylaxis effectively reduces CMV infection after haplo-SCT. 8,9However, its impact on EBV remains unclear.This study compared letermovir recipients (letermovir group) to a control group receiving standard polymerase chain reaction (PCR)-guided pre-emptive therapy (non-letermovir group) in two independent cohorts.In both cohorts, letermovir significantly reduced clinically significant CMV infection and refractory CMV infection within 180 days after the transplant.While the incidence of EBV viremia was similar in the two groups, letermovir recipients exhibited higher peak EBV titers and had an increased risk of post-transplant lymphoproliferative disorder (PTLD) within the first 180 days.In both univariate and multivariate analyses, the use of letermovir was significantly linked to a higher risk of P...