- |||||||||| cyclophosphamide intravenous / Generic mfg.
[VIRTUAL] Autologous Hematopoietic Stem Cell Transplantation in Multiple Sclerosis (aHSCT-in-MS): The Zurich Experience 24 Months after Approval () - Aug 16, 2020 - Abstract #MSDC2020MSDC_387; Conditioning high-dose chemotherapy comprises BEAM-ATG, i.e. BCNU, etoposide, cytarabine, melphalan before- and ATG (d+1 and +2: 3.75 mg/kg/d) after stem cell re-transfusion (d0).Results 26 MS patients (13 females, 13 males) with a mean age of 40.8±7.8 years, mean disease duration of 8.9±4.8 years and a mean expanded disease status scale (EDSS) score of 5.0±1.2 have been treated with aHSCT...Although a substantial proportion of patients reported improvements of neurological functions and less fatigue, follow-up is too short to comment on long-term outcomes.Conclusions The safety profile of aHSCT-in-MS is acceptable, but requires vigilant monitoring and optimized antibacterial and antiviral prophylactic care. Regarding the increased risk of CMV reactivation (4/7 CMV-seropositive patients) and herpes zoster (2/26), we decided to establish prophylaxis with the CMV inhibitor letermovir in CMV-seropositive patients and to vaccinate all patients with Shingrix® after transplantation.
- |||||||||| Prevymis (letermovir) / Merck (MSD)
Trial completion date, Trial primary completion date: Letermovir Treatment for Refractory or Resistant Cytomegalovirus Infection (clinicaltrials.gov) - Aug 8, 2020 P2, N=32, Recruiting, These data support the reduction in clinical dosage of letermovir (to 240 mg) upon coadministration with cyclosporine. Trial completion date: Jul 2021 --> Jul 2022 | Trial primary completion date: Dec 2020 --> Dec 2021
- |||||||||| Tembexa (brincidofovir oral) / SymBio Pharma, Prevymis (letermovir) / Merck (MSD), maribavir (TAK-620) / Takeda, GSK
Journal: Resistant or refractory cytomegalovirus infections after hematopoietic cell transplantation: diagnosis and management. (Pubmed Central) - Aug 4, 2020 Many advances have been made to optimize future clinical trials for management of refractory or resistant CMV infections, and to better understand new resistance mechanisms to novel drugs. New drugs or strategies with limited toxicities are needed to improve outcomes of difficult to treat CMV infections in HCT recipients.
- |||||||||| Prevymis (letermovir) / Merck (MSD)
Biomarker, Clinical, PK/PD data, Journal: Pharmacogenetic Analysis of OATP1B1, UGT1A1, and BCRP Variants in Relation to the Pharmacokinetics of Letermovir in Previously Conducted Clinical Studies. (Pubmed Central) - Jul 29, 2020 SLCO1B1 variant rs2306283, UGT1A1*28 TA promoter repeat, and BCRP variant rs2231142 had no effect on letermovir PK. Together, these data suggest that variants of enzymes and transporters that are involved in the disposition of letermovir in vitro may account for some variability in letermovir PK, but do not affect exposure to a clinically relevant extent.
- |||||||||| Prevymis (letermovir) / Merck (MSD), tacrolimus / Generic mfg., Vistide (cidofovir) / Gilead
Clinical, Journal: Suppression of CMV Infection with Letermovir in a Kidney Transplant Patient. (Pubmed Central) - Jul 17, 2020 Furthermore, we observed significant drug interactions between letermovir and tacrolimus. Cytomegalovirus (CMV) disease with resistance to ganciclovir (GCV) is difficult to manage in transplant patients.Letermovir may become a new option for treatment and prophylaxis of GCV-resistant CMV infection, but assessment of treatment response is difficult.Letermovir may lead to drug interactions via CYP3A4.
- |||||||||| Campath (alemtuzumab) / Sanofi, tacrolimus / Generic mfg., doxycycline / Generic mfg., Pierre Fabre
[VIRTUAL] Disseminated Histoplasmosis in Lung Transplant Recipient Presenting as Hemophagocytic Lymphohistocytosis (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_5878; Tacrolimus was changed to cyclosporine...This case highlights the importance of bone marrow biopsy in the work-up for pancytopenia and infection remains a serious concern in lung transplant patient presenting with fever of unknown origin. It also raises the question; should all lung transplant donor and/or recipient be screened for histoplasmosis?
- |||||||||| [VIRTUAL] EPIDEMIOLOGY, RISK FACTORS AND OUTCOMES OF CMV INFECTION IN ADULTS UNDERGOING ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT (HCT): A SINGLE INSTITUTIONAL COHORT STUDY (ePoster Area) - Jul 3, 2020 - Abstract #EBMT2020EBMT_4956;
From a retrospective cohort of 1,283 seropositive adults who underwent HCT at Stanford University from January 2009 to May 2019, we analyzed 1,107 adults after the exclusion of patients on letermovir (N=78), who received a second HCT (N=78), or were not screened (N=8)...From 2015-2017 umbilical cord blood (UCB) recipients received valacyclovir 2000 mg thrice daily...Median overall antiviral exposure through D+100 was 30 days (range 0-100); ganciclovir (54%) was the most common initial agent used [median exposure 24 days (range 1-92)] vs 39% valganciclovir [median 25d (1-93d)] vs 7% foscarnet [median 10d (0-53d)]... Despite effective preemptive therapy strategies, CMV infection remains a significant and common complication of HCT and to have a measurable impact on patients and healthcare system.
- |||||||||| [VIRTUAL] EPIDEMIOLOGY, RISK FACTORS AND OUTCOMES OF CMV INFECTION IN ADULTS UNDERGOING ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT (HCT): A SINGLE INSTITUTIONAL COHORT STUDY (ePoster Area) - Jul 3, 2020 - Abstract #EBMT2020EBMT_4955;
From a retrospective cohort of 1,283 seropositive adults who underwent HCT at Stanford University from January 2009 to May 2019, we analyzed 1,107 adults after the exclusion of patients on letermovir (N=78), who received a second HCT (N=78), or were not screened (N=8)...From 2015-2017 umbilical cord blood (UCB) recipients received valacyclovir 2000 mg thrice daily...Median overall antiviral exposure through D+100 was 30 days (range 0-100); ganciclovir (54%) was the most common initial agent used [median exposure 24 days (range 1-92)] vs 39% valganciclovir [median 25d (1-93d)] vs 7% foscarnet [median 10d (0-53d)]... Despite effective preemptive therapy strategies, CMV infection remains a significant and common complication of HCT and to have a measurable impact on patients and healthcare system.
- |||||||||| [VIRTUAL] EPIDEMIOLOGY, RISK FACTORS AND OUTCOMES OF CMV INFECTION IN ADULTS UNDERGOING ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT (HCT): A SINGLE INSTITUTIONAL COHORT STUDY (ePoster Area) - Jul 3, 2020 - Abstract #EBMT2020EBMT_4954;
From a retrospective cohort of 1,283 seropositive adults who underwent HCT at Stanford University from January 2009 to May 2019, we analyzed 1,107 adults after the exclusion of patients on letermovir (N=78), who received a second HCT (N=78), or were not screened (N=8)...From 2015-2017 umbilical cord blood (UCB) recipients received valacyclovir 2000 mg thrice daily...Median overall antiviral exposure through D+100 was 30 days (range 0-100); ganciclovir (54%) was the most common initial agent used [median exposure 24 days (range 1-92)] vs 39% valganciclovir [median 25d (1-93d)] vs 7% foscarnet [median 10d (0-53d)]... Despite effective preemptive therapy strategies, CMV infection remains a significant and common complication of HCT and to have a measurable impact on patients and healthcare system.
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