ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Microbiology
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1558637
This article is part of the Research TopicImmunological Advancements in Hematological Therapies: Exploring HSCT and CAR-T IntegrationView all 3 articles
Real-world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation: a single center observational study
Provisionally accepted
- 1Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- 2Wuhan Union Hospital, Wuhan, Hebei Province, China
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Objectives: To compare the efficacy and safety of letermovir and ganciclovir for cytomegalovirus (CMV) prophylaxis in adolescent patients (aged 14-17 years) undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT).Methods: This observational and single-center study collected data from February 2023 and April 2024.Results: The cumulative incidence of CMV DNAemia following HSCT was 44.4% in the letermovir group (n=20) and 66.3% in the control group (n=32) receiving ganciclovir. Notably, the cumulative incidence of clinically significant CMV infection (csCMVi) was significantly reduced in the letermovir group compared with control patients (11.0% vs 41.3%, p=0.021). Among patients diagnosed with grades Ⅱ-Ⅳ acute graft-versus-host disease (aGVHD), a significantly lower proportion of individuals in the letermovir group presented CMV DNAemia than in the control group (20.0% vs 73.3%, p=0.013). The common adverse events observed in the letermovir group were aGVHD (60.0%), diarrhea (25.0%), and nausea (15.0%).Leukopenia was reported in only one patient, and did not necessitate an adjustment of letermovir dosage.Conclusions: In this single-center real-world study, letermovir exhibited a favourable efficacy and safety profile for CMV prophylaxis in adolescent patients undergoing HSCT. However, further prospective multi-center studies are warranted to validate our conclusion in adolescent patients.
Keywords: adolescents, Cytomegalovirus, 53 Letermovir, Ganciclovir 54, HSCT = hematopoietic stem cell transplant
Received: 10 Jan 2025; Accepted: 15 Apr 2025.
Copyright: © 2025 Xu, lu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huafang Wang, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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