Skip to main content
Journal cover image

Letermovir treatment of cytomegalovirus infection or disease in solid organ and hematopoietic cell transplant recipients.

Publication ,  Journal Article
Linder, KA; Kovacs, C; Mullane, KM; Wolfe, C; Clark, NM; La Hoz, RM; Smith, J; Kotton, CN; Limaye, AP; Malinis, M; Hakki, M; Mishkin, A ...
Published in: Transplant infectious disease : an official journal of the Transplantation Society
August 2021

Few options are available for cytomegalovirus (CMV) treatment in transplant recipients resistant, refractory, or intolerant to approved agents. Letermovir (LET) is approved for prophylaxis in hematopoietic cell transplant (HCT) recipients, but little is known about efficacy in CMV infection. We conducted an observational study to determine the patterns of use and outcome of LET treatment of CMV infection in transplant recipients.Patients who received LET for treatment of CMV infection were identified at 13 transplant centers. Demographic and outcome data were collected.Twenty-seven solid organ and 21 HCT recipients (one dual) from 13 medical centers were included. Forty-five of 47 (94%) were treated with other agents prior to LET, and 57% had a history of prior CMV disease. Seventy-seven percent were intolerant to other antivirals; 32% were started on LET because of resistance concerns. Among 37 patients with viral load < 1000 international units (IU)/ml at LET initiation, two experienced >1 log rise in viral load by week 12, and no deaths were attributed to CMV. Ten patients had viral load > 1000 IU/ml at LET initiation, and six of 10 (60%) had a CMV viral load < 1000 IU/ml at completion of therapy or last known value. LET was discontinued in two patients for an adverse event.Patients treated with LET with viral load < 1000 IU/ml had good virologic outcomes. Outcomes were mixed when LET was initiated at higher viral loads. Further studies on combination therapy or alternative LET dosing are needed.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Transplant infectious disease : an official journal of the Transplantation Society

DOI

EISSN

1399-3062

ISSN

1398-2273

Publication Date

August 2021

Volume

23

Issue

4

Start / End Page

e13687

Related Subject Headings

  • Viral Load
  • Transplant Recipients
  • Surgery
  • Quinazolines
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • Cytomegalovirus Infections
  • Antiviral Agents
  • Acetates
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Linder, K. A., Kovacs, C., Mullane, K. M., Wolfe, C., Clark, N. M., La Hoz, R. M., … Kaul, D. R. (2021). Letermovir treatment of cytomegalovirus infection or disease in solid organ and hematopoietic cell transplant recipients. Transplant Infectious Disease : An Official Journal of the Transplantation Society, 23(4), e13687. https://doi.org/10.1111/tid.13687
Linder, Kathleen A., Christopher Kovacs, Kate M. Mullane, Cameron Wolfe, Nina M. Clark, Ricardo M. La Hoz, Jeannina Smith, et al. “Letermovir treatment of cytomegalovirus infection or disease in solid organ and hematopoietic cell transplant recipients.Transplant Infectious Disease : An Official Journal of the Transplantation Society 23, no. 4 (August 2021): e13687. https://doi.org/10.1111/tid.13687.
Linder KA, Kovacs C, Mullane KM, Wolfe C, Clark NM, La Hoz RM, et al. Letermovir treatment of cytomegalovirus infection or disease in solid organ and hematopoietic cell transplant recipients. Transplant infectious disease : an official journal of the Transplantation Society. 2021 Aug;23(4):e13687.
Linder, Kathleen A., et al. “Letermovir treatment of cytomegalovirus infection or disease in solid organ and hematopoietic cell transplant recipients.Transplant Infectious Disease : An Official Journal of the Transplantation Society, vol. 23, no. 4, Aug. 2021, p. e13687. Epmc, doi:10.1111/tid.13687.
Linder KA, Kovacs C, Mullane KM, Wolfe C, Clark NM, La Hoz RM, Smith J, Kotton CN, Limaye AP, Malinis M, Hakki M, Mishkin A, Gonzalez AA, Prono MD, Ostrander D, Avery R, Kaul DR. Letermovir treatment of cytomegalovirus infection or disease in solid organ and hematopoietic cell transplant recipients. Transplant infectious disease : an official journal of the Transplantation Society. 2021 Aug;23(4):e13687.
Journal cover image

Published In

Transplant infectious disease : an official journal of the Transplantation Society

DOI

EISSN

1399-3062

ISSN

1398-2273

Publication Date

August 2021

Volume

23

Issue

4

Start / End Page

e13687

Related Subject Headings

  • Viral Load
  • Transplant Recipients
  • Surgery
  • Quinazolines
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • Cytomegalovirus Infections
  • Antiviral Agents
  • Acetates
  • 3202 Clinical sciences