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    CMV Infection in Hematopoietic Stem Cell Transplantation: Prevention and Treatment Strategies

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    Author
    Jakharia, Niyati
    Howard, Dianna
    Riedel, David J
    Date
    2021-07-21
    Journal
    Current Treatment Options in Infectious Diseases
    Publisher
    Springer Nature
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1007/s40506-021-00253-w
    http://www.ncbi.nlm.nih.gov/pmc/articles/pmc8294301/
    Abstract
    Purpose of review: Cytomegalovirus (CMV) remains a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (Allo-HSCT). New strategies and methods for prevention and management of CMV infection are urgently needed. We aim to review the new developments in diagnostics, prevention, and management strategies of CMV infection in Allo-HSCT recipients. Recent findings: The approval of the novel anti-CMV drug letermovir in 2017 has led to an increase in the use of antiviral prophylaxis as a preferred approach for prevention in many centers. Real-world studies have shown efficacy similar to the clinical trial. CMV-specific T cell-mediated immunity assays identify patients with immune reconstitution and predict disease progression. Phase 2 trials of maribavir have shown its efficacy as preemptive therapy and treatment of resistant and refractory CMV infections. Adoptive T cell therapy is an emerging option for treatment of refractory and resistant CMV. Of the different CMV vaccine trials, PepVax has shown promising results in a phase 1 trial. Summary: CMV cell-mediated immunity assays have potential to be used as an adjunctive test to develop individualized management plan by identifying the patients who develop immune reconstitution; however, further prospective interventional studies are needed. Maribavir and adoptive T cell therapy are promising new therapies for treatment of CMV infections. CMV vaccine trials for prevention are also under way.
    Rights/Terms
    © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.
    Keyword
    CMV infection
    Hematopoietic stem cell transplantation
    Letermovir
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16252
    ae974a485f413a2113503eed53cd6c53
    10.1007/s40506-021-00253-w
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