The promising efficacy of a risk-based ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
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]
Faure, Emmanuel [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Behal, Helene [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Chauvet, Paul [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE (Ex-Liric)]
Srour, Micha [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
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]
Pathogenèse virale du diabète de type 1 - ULR 3610
Simon, Nicolas [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - ULR 7365
Vuotto, Fanny [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU 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]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Beauvais, David [Auteur]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Faure, Emmanuel [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Behal, Helene [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Chauvet, Paul [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE (Ex-Liric)]
Srour, Micha [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
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]
Pathogenèse virale du diabète de type 1 - ULR 3610
Simon, Nicolas [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - ULR 7365
Vuotto, Fanny [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU 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]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Beauvais, David [Auteur]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
Journal title :
Blood Advances
Abbreviated title :
Blood Adv
Volume number :
7
Pages :
856-865
Publisher :
The American Society of Hematology
Publication date :
2022-11-11
ISSN :
2473-9537
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 >
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
Audience :
Internationale
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Collections :
Submission date :
2023-05-25T02:23:09Z
2023-06-28T09:31:47Z
2023-06-28T09:31:47Z