HSCT and CMV background

HSCT patients are at risk for CMV reactivation and associated mortality1,2

All CMV-seropositive recipients [R+] are at high risk of CMV reactivation1

CMV infection has been shown to occur after allogeneic HSCT in approximately 60% to 80% of CMVseropositive patients without CMV prophylaxis3,4

Any level of CMV has been associated with increased risk of mortality in the first year post-HSCT2

HSCT patients with any positive viremia had 2.6 times greater risk of overall mortality than patients with no viremia up to 60 days after HSCT2

CMV Viral Load as a Time-Dependent Risk Factor for Mortality 1 Year After HSCT (n=926)2,a

Results from a large, retrospective, noninterventional cohort study of previously collected CMV viremia and clinical outcome measures (n=1037)2

CMV reactivation can occur as early as the day of transplant5

More than 30% of HSCT patients who were CMV-seropositive or had a seropositive donor had CMV infection within 1 month post-transplant2

Incidence of CMV Reactivation in HSCT Patients Who Were CMV-Seropositive or Had a Seropositive Donor Through 12 Months Post-Transplant2

Results from a large, retrospective, noninterventional cohort study of previously collected CMV viremia and clinical outcome measures (n=1037)2
CI, confidence interval Viral load was a threshold variable. Data were assessed using multivariable Cox proportional modeling.2

References

  • 1.

    George B, Pati N, Gilroy N, et al. Pre-transplant cytomegalovirus (CMV) serostatus remains the most important determinant of CMV reactivation after allogeneic hematopoietic stem cell transplantation in the era of surveillance and preemptive therapy. Transpl Infect Dis. 2010;12(4):322-329.

  • 2.

    Green ML, Leisenring W, Xie H, et al. Cytomegalovirus viral load and mortality after haematopoietic stem cell transplantation in the era of pre-emptive therapy: a retrospective cohort study. Lancet Haematol. 2016;3:e119-e127.

  • 3.

    Ljungman P, Hakki M, Boeckh M, et al. Cytomegalovirus in hematopoietic stem cell transplant recipients. Hematol Oncol Clin N Am. 2011;25(1):151-169.

  • 4.

    Sousa H, Boutolleau D, Ribeiro J, et al. Cytomegalovirus infection in patients who underwent allogeneic hematopoietic stem cell transplantation in Portugal: a five-year retrospective review. Biol Blood Marrow Transplant. 2014;20(12):1958-1967.

  • 5.

    Hammerstrom AE, Lombardi LR, Pingali SR, et al. Prevention of cytomegalovirus reactivation in haploidentical stem cell transplantation. Biol Blood Marrow Transplant. 2018;24(2):353-358.

  • 6.

    Marty FM, Ljungman P, Chemaly RF, et al. Letermovir prophylaxis for cytomegalovirus in hematopoieticcell transplantation. N Engl J Med. 2017;377(25):2433-2444.

  • 7.

    SPC Juli 2018

SE-CYT-00002