医学
巨细胞病毒
造血干细胞移植
巨细胞病毒感染
免疫学
移植
来氟米特
疾病
临床试验
免疫疗法
重症监护医学
内科学
人巨细胞病毒
免疫系统
病毒性疾病
疱疹病毒科
病毒
甲氨蝶呤
作者
Fatima Allaw,Sara F. Haddad,Johnny Zakhour,Souha S. Kanj
标识
DOI:10.1016/j.ijantimicag.2023.106860
摘要
Cytomegalovirus (CMV) is a common infection encountered in immunocompromised patients. It is associated with high morbidity and mortality, particularly in patients undergoing allogeneic (allo-) haematopoietic stem cell transplantation (HSCT). This review presents the most recent management strategies for CMV infection in allo-HSCT recipients. Pre-emptive treatment (PET) consists of frequent monitoring of CMV polymerase chain reaction (PCR) after HSCT; this has been the standard of care for prevention of CMV for many years, given the potential drug toxicity associated with the traditional drugs used as prophylaxis. However, letermovir, recently approved as a chemoprophylactic agent for prevention of CMV, has shown great efficacy in randomized clinical trials and real-world data. Treatment of CMV disease is becoming increasingly difficult, and must take into account the patient's risk profile and the potential for CMV drug resistance. Different treatment strategies exist for refractory and resistant CMV disease. Maribavir is a new drug that showed promising results in the treatment of refractory and resistant CMV disease. Other alternative treatments, such as cellular adoptive immunotherapy, artesunate and leflunomide, may play an adjunctive role in the treatment of challenging cases; however, further investigation is warranted.
科研通智能强力驱动
Strongly Powered by AbleSci AI