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The interplay between Epstein-Barr Virus and Cytomegalovirus reactivation following allogeneic hematopoietic cell transplantation in the era of primary CMV prophylaxis.
Clin Microbiol Infect
August 2025
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Objectives: Epstein-Barr virus (EBV) reactivation following allogeneic hematopoietic cell transplantation (allo-HCT) is associated with increased mortality and possible post-transplant lymphoproliferative disorder (PTLD). With the lack of prophylactic agents, identifying modifiable risk factors to prevent EBV-related mortality is desired. Cytomegalovirus (CMV) DNAemia has been previously associated with EBV DNAemia; the impact of letermovir prophylaxis on this association remains unclear.
View Article and Find Full Text PDFFURTHER EVIDENCE SUPPORTING THE USE OF LETERMOVIR FOR CMV PROPHYLAXIS - IT'S NOT ONLY LEUKOPENIA.
Am J Transplant
August 2025
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway; Department of Pharmacy, University of Oslo, Oslo, Norway.
Probable reactivation from latency of multi-drug resistant cytomegalovirus in a lung transplant recipient: a case report.
Am J Transplant
August 2025
Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, CA. Electronic address:
Whether ganciclovir-resistant cytomegalovirus (ganR-CMV) can establish latency and reactivate absent any selective drug pressure is unknown and has implications for selecting empiric antiviral therapy in patients with prior ganR-CMV. A CMV-seronegative patient underwent bilateral lung transplant from a CMV-seropositive donor and developed biopsy-confirmed CMV colitis with ganR-CMV (UL97 genotype: M460I, A594E; UL54 genotype: F412L, E756D) four years post-transplant despite prolonged valganciclovir prophylaxis. Foscarnet therapy led to CMV DNAemia clearance and disease resolution.
View Article and Find Full Text PDFCytomegalovirus prophylaxis with letermovir in pediatric (birth to <18 years of age) hematopoietic cell transplant recipients: pharmacokinetics, efficacy, and safety results of a Phase 2b study.
Antimicrob Agents Chemother
August 2025
Merck & Co., Inc., Rahway, New Jersey, USA.
Letermovir, a cytomegalovirus (CMV) terminase complex inhibitor, was first approved for prophylaxis of CMV infection and disease in adult CMV-seropositive allogeneic hematopoietic cell transplant (HCT) recipients (R+). This study evaluated the pharmacokinetics (PK), efficacy, and safety of letermovir in pediatric R+ allogeneic HCT recipients. In this Phase 2b, single-arm, open-label study, 65 participants were enrolled sequentially in three age groups (AG; AG1, 12 to <18 years; AG2, 2 to <12 years; and AG3, birth to <2 years).
View Article and Find Full Text PDFLetermovir and Tacrolimus Drug-Drug Interaction in a Pediatric Kidney Transplant Patient: A Case Report and Review of the Literature.
Pediatr Transplant
September 2025
Department of Pharmacy, BC Children's Hospital, Vancouver, British Columbia, Canada.
Background: Cytomegalovirus (CMV) viremia is one of the most common opportunistic infections following solid organ transplant (SOT) in pediatric patients and can be associated with significant morbidity. Valganciclovir is the preferred antiviral medication used for CMV prophylaxis in high-risk kidney transplant recipients, but its use is limited by myelosuppression. Letermovir is an alternative antiviral medication with lower rates of neutropenia.
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