Title :

The promising efficacy of a risk-based letermovir use strategy in CMV-positive allogeneic hematopoietic cell recipients.

Author(s) :

Sourisseau, Mathilde [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Université de Lille
Faure, Emmanuel [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL]
Behal, Helene [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Chauvet, Paul [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Srour, Micha [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Capes, Antoine [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Coiteux, Valérie [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Magro, Leonardo [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Alfandari, Serge [Auteur]
Centre Hospitalier Gustave Dron [Tourcoing]
Alidjinou, Enagnon-Kazali [Auteur]
Laboratoire de Virologie - ULR 3610 [Laboratoire de Virologie]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Simon, Nicolas [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 [GRITA]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Vuotto, Fanny [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Université de Lille
Karam, Micheline [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Faure, Karine [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL]
Yakoub-Agha, Ibrahim [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Beauvais, David [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U 1192 [PRISM]

Journal title :

Blood advances

Pages :

856-865

Publisher :

The American Society of Hematology

Publication date :

2022-11-11

ISSN :

2473-9529

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Letermovir is the first approved drug for cytomegalovirus (CMV) infection prophylaxis in adult patients who are CMV positive undergoing allogeneic hematopoietic cell transplantation (allo-HCT). Because CMV infection risk ...
Show more >Letermovir is the first approved drug for cytomegalovirus (CMV) infection prophylaxis in adult patients who are CMV positive undergoing allogeneic hematopoietic cell transplantation (allo-HCT). Because CMV infection risk varies from patient to patient, we evaluated whether a risk-based strategy could be effective. In this single-center study, all consecutive adult patients who were CMV positive and underwent allo-HCT between 2015 and 2021 were included. During period 1 (2015-2017), letermovir was not used, whereas during period 2 (2018-2021), letermovir was used in patients at high risk but not in patients at low risk, except in those receiving corticosteroids. In patients at high risk, the incidence of clinically significant CMV infection (csCMVi) in period 2 was lower than that in period 1 (P < .001) by week 14 (10.5% vs 51.6%) and week 24 (16.9% vs 52.7%). In patients at low risk, although only 28.6% of patients received letermovir in period 2, csCMVi incidence was also significantly lower (P = .003) by week 14 (7.9% vs 29.0%) and week 24 (11.2% vs 33.3%). Among patients at low risk who did not receive letermovir (n = 45), 23 patients (51.1%) experienced transient positive CMV DNA without csCMVi, whereas 17 patients (37.8%) experienced negative results. In both risk groups, the 2 periods were comparable for CMV disease, overall survival, progression-free survival, relapse, and nonrelapse mortality. We concluded that a risk-based strategy for letermovir use is an effective strategy which maintains the high efficacy of letermovir in patients at high risk but allows some patients at low risk to not use letermovir.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Collections :

• Centre d'Infection et d'Immunité de Lille (CIIL) - U1019 - UMR 9017

Source :

Harvested from HAL