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- || Clinical, Review, Journal: Make Sure You Have a Safety Net: Updates in the Prevention and Management of Infectious Complications in Stem Cell Transplant Recipients. (Pubmed Central) - Apr 6, 2020
We discuss novel drugs, such as letermovir, isavuconazole, meropenem-vaborbactam and bezlotoxumab; weigh the pros and cons of using fluoroquinolone prophylaxis during neutropenia after stem cell transplantation; and provide updates on important viral infections after hematopoietic stem cell transplant (HSCT). Optimizing the prevention and management of infectious diseases by using the best available evidence will contribute to better outcomes for stem cell transplant recipients, and provide the best possible "safety net" for these immunocompromised hosts.
- | Prevymis (letermovir) / Merck (MSD), Campath (alemtuzumab) / Sanofi
New P2 trial: Letermovir for the Prevention of Cytomegalovirus Reactivation in Patients With Hematological Malignancies Treated With Alemtuzumab (clinicaltrials.gov) - Mar 18, 2020
P2, N=30, Not yet recruiting, Sponsor: Ohio State University Comprehensive Cancer Center
- Disseminated Histoplasmosis in Lung Transplant Recipient Presenting as Hemophagocytic Lymphohistocytosis (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area K) - Mar 15, 2020 - Abstract #ATS2020ATS_8518;
Tacrolimus was changed to cyclosporine...We postulate that this patient acquired H. capsulatum from transplanted donor lung or via reactivation of latent infection.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?
- | Vistide (cidofovir) / Gilead
Review, Journal: In vitro comparison of currently available and investigational antiviral agents against pathogenic human double-stranded DNA viruses: A systematic literature review. (Pubmed Central) - Mar 15, 2020
Brincidofovir and cidofovir have broad-spectrum activity, and brincidofovir has the lowest EC values. These findings could assist clinical practice and developmental research.
- || Prevymis (letermovir) / Merck (MSD), maribavir (TAK-620) / Takeda, GSK
Clinical, Review, Journal: Clinical development of letermovir and maribavir: Overview of human cytomegalovirus drug resistance. (Pubmed Central) - Mar 15, 2020
MBV-resistant mutations also emerged in the UL27 gene in vitro and could compensate for the inhibition of pUL97 kinase activity by MBV. Thus, LMV and probably MBV will broaden the armentarium of antiviral drugs available for the prevention and treatment of HCMV infections.
- Prevymis (letermovir) / Merck (MSD)
[VIRTUAL] PRINCIPAL COMPONENTS ANALYSIS TO IDENTIFY BIOMARKERS PREDICTIVE OF NON-AIDS EVENTS ([VIRTUAL]) - Mar 2, 2020 - Abstract #CROI2020CROI_1145;
PCA is a useful high-dimensional analytic approach to reduce the number of statistical comparisons, to characterize unique, meaningful cytokine profiles, and to identify specific biomarkers to consider for endpoints in future interventional trials. In our analysis we confirmed that sTNFrI and II and suPAR were the strongest predictors of non-AIDS events, supporting sTNFrII as the primary endpoint of ACTG studies of letermovir and anti-CMV vaccine.
- ||| Prevymis (letermovir) / Merck (MSD)
#TCTM20 last day. Chaired by @PergamIC Selection of CMV oral abstracts. Polyfunctional cmv immunity post letermovir and cmv incidence post haplo PTCy @NCICancer (Twitter) - Feb 23, 2020
- ||| Prevymis (letermovir) / Merck (MSD)
#TCTM20 Zamora: assessing CMV T cell responses in Letermovir treated vs controls. Decreased IE Ag and (+/-) pp65 responses (Twitter) - Feb 23, 2020
- | Prevymis (letermovir) / Merck (MSD)
Clinical, Journal: Use of Letermovir as Salvage Therapy for Drug-resistant CMV Retinitis: A Case Series. (Pubmed Central) - Feb 22, 2020
All patients improved clinically without known adverse drug events. However, three patients failed to maintain virologic suppression, including two patients who developed genotypically-confirmed resistance to letermovir while on therapy.
- ||| Prevymis (letermovir) / Merck (MSD)
#TCTM20 Milano: CMV reactivation has historically been a major thorn of UCBT, but letermovir addresses this nicely (Twitter) - Feb 20, 2020
- | Prevymis (letermovir) / Merck (MSD), Vistide (cidofovir) / Gilead
Journal: Letermovir (Prevymis) for CMV prophylaxis. (Pubmed Central) - Feb 15, 2020
However, three patients failed to maintain virologic suppression, including two patients who developed genotypically-confirmed resistance to letermovir while on therapy. No abstract available
- | Prevymis (letermovir) / Merck (MSD)
Review, Journal: Targeting the terminase: An important step forward in the treatment and prophylaxis of human cytomegalovirus infections. (Pubmed Central) - Feb 14, 2020
Herein we examine the HCMV terminase as a target for drugs and review several inhibitors discovered by both lead-directed medicinal chemistry and by target-specific design. In addition to producing clinically active compounds the research also has furthered the understanding of the role and function of the terminase itself.
- Prevymis (letermovir) / Merck (MSD)
[VIRTUAL] CMV-SPECIFIC FUNCTIONAL IMMUNE RECONSTITUTION IS SLOWER AFTER UMBILICAL CORD BLOOD COMPARED WITH MATCHED SIBLING DONOR HEMATOPOIETIC CELL TRANSPLANTATION (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_2373;
Our data suggest that CMV-specific functional immune reconstitution is slower within first year of HCT in CMV seropositive patients receiving UCB vs. PB MSD. Our findings support implementing strategies to suppress CMV reactivation such as letermovir and to accelerate immune reconstitution such as CMV-vaccines or CMV-specific T-cell adoptive transfer in CMV seropositive patients receiving UCB HCT.
- Actemra IV (tocilizumab) / Roche, JW Pharma, mycophenolate mofetil / Generic mfg., cyclosporine / Generic mfg.
[VIRTUAL] ADDITION OF TOCILIZUMAB TO CYCLOSPORINE-A AND MYCOPHENOLATE MOFETIL FOR GRAFT-VERSUS-HOST DISEASE (GVHD) PROPHYLAXIS SIGNIFICANTLY ABROGATES SEVERE ACUTE GVHD AFTER DOUBLE-UNIT CORD BLOOD TRANSPLANTATION IN ADULTS (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_2369;
P2
While many pts developed upper GI aGVHD, the marked reduction in lower GI aGVHD supports preferential reduction of T-cell homing to the lower gut. Investigation of this approach including aGVHD treatment responses, immune recovery & correlative biomarker/ microbiota studies are ongoing.
- Prevymis (letermovir) / Merck (MSD)
[VIRTUAL] CMV SEROPOSITIVITY DRIVES T CELL RECONSTITUTION AFTER CD34-SELECTED ALLOGENEIC HCT DESPITE REDUCTION OF VIREMIA WITH LETERMOVIR (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_2004;
To our knowledge, these are the first data to indicate that prior CMV exposure exerts effects on T-cell reconstitution independent of quantifiable viremia. Further investigation into the mechanisms underlying these findings will shed greater light on the complexity of the interaction between CMV and host T-cell response and, perhaps, inform the development of future adoptive cell therapy approaches.
- Prevymis (letermovir) / Merck (MSD)
[VIRTUAL] USE OF LETERMOVIR IN OFF-LABEL INDICATIONS: INFECTIOUS DISEASES WORKING PARTY EBMT RETROSPECTIVE STUDY (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1986;
The efficacy of the use of LMV as secondary prophylaxis was high. The preliminary experience with the use of LMV for treatment of patients with refractory/resistant CMV infection/disease showed good short-term effect.
- [VIRTUAL] EPIDEMIOLOGY, RISK FACTORS AND OUTCOMES OF CMV INFECTION IN ADULTS UNDERGOING ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT (HCT): A SINGLE INSTITUTIONAL COHORT STUDY (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1985;
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] LETERMOVIR AS PRE-EMPTIVE THERAPY FOR RESISTANT CYTOMEGALOVIRUS INFECTION AFTER ALLOGENEIC STEM CELL TRANSPLANTATION (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1527;
In the reported case, after trying all the approved therapeutic options, letermovir was the only antiviral that achieved an effective and long-lasting response despite multiple episodes of GvHD that needed adjustment of the inmunosupressive therapy. In the setting of clinical resistance or when the drug is not used as prophylaxis, letermovir can lead to an optimal control of CMV DNAemia with a safety profile.
- Prevymis (letermovir) / Merck (MSD), Foscavir (foscarnet) / Pfizer, Clinigen, Valcyte (valganciclovir) / Roche, Mitsubishi Tanabe
[VIRTUAL] USE OF CMV-HYPERIMMUNE GLOBULINS (CMV-HYG) AS PRE-EMPTIVE THERAPY OR TREATMENT OF CMV INFECTION IN HSCT RECIPIENTS (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1522;
Our preliminary data indicate that the use of CMV-HyG in combination with antiviral therapy in patients with multiple CMV reactivations, and in patients with CMV disease might contribute to an optimal control of the infection. Further prospective studies including a large number of patients are needed to confirm our results.
- Prevymis (letermovir) / Merck (MSD)
[VIRTUAL] RISK FACTORS FOR CMV REACTIVATION AND DISEASE AMONG HEMATOPOIETIC STEM CELL TRANSPLANT RECIPIENTS - DEFINING THE TARGET POPULATION FOR LETERMOVIR PROPHYLAXIS (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1514;
Pre-emptive treatment with antivirals and CMV specific IgG is highly effective. CMV disease is rare and almost exclusively associated with severe GvHD.
- Prevymis (letermovir) / Merck (MSD), tacrolimus / Generic mfg., cyclophosphamide intravenous / Generic mfg.
[VIRTUAL] VERSATILE EFFECTS OF LETERMOVIR PROPHYLAXIS FOR CYTOMEGALOVIRUS ON ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION: A SINGLE-INSTITUTION ANALYSIS (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1504;
GVHD prophylaxis consisted of tacrolimus and short-term methotrexate with or without low-dose anti-thymocyte globulin... The result of this study suggested that prophylactic use of LET might reduce TRM via not only suppression of CMV disease but also reduction of CMV-indirectly-related complications such as clinically significant acute GVHD.
- valacyclovir / Generic mfg.
[VIRTUAL] HIGH DOSE VALACICLOVIR AS CMV PROPHYLAXIS IN ALLOGENEIC HAEMATOPOIETIC STEM CELL TRANSPLANTATION (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1496;
This may reduce requirement for myelotoxic CMV treatment and inpatient hospital admission. CMV infection following HDvala cessation remains a risk, and ongoing monitoring is required.
- Cytovene (ganciclovir) / Roche, cyclophosphamide intravenous / Generic mfg.
[VIRTUAL] INTENSIFICATION OF CMV PROPHYLAXIS WITH THE USE OF GANCICLOVIR DURING THE CONDITIONING IN HAPLOIDENTICAL TRANSPLANTATION WITH POST-TRANSPLANTATION CYCLOPHOSPHAMIDE. COMPARISON WITH A STANDARD STRATEGY. 113 PATIENTS (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1493;
Whit the caveat that in the group those who received ganciclovir there were more patients on steroids, our study shows that in the field of Haplo-PTCy the intensification of CMV prophylaxis with the addition of full dose of ganciclovir for seven days during the conditioning to the standard strategy does not decrease neither the incidence of CMV reactivation nor the time of first viremia in seropositive patients. With the availability of new medication for CMV prevention in the market it is worth to explore the use of it in this high risk population.
- Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
[VIRTUAL] INCIDENCE AND IMPACT OF EPSTEIN-BARR VIRUS EVENTS IN THE EARLY PHASE AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1490;
Despite better approaches with weekly surveillance, monitoring and pre-emptive therapy for EBV, EBV-events are associated with reduced overall survival. The impact of letermovir prophylaxis preventing CMV-events is expected to improve clinical management for CMV, but its impact on EBV-events is unknown.
- Prevymis (letermovir) / Merck (MSD)
[VIRTUAL] LETERMOVIR PROPHYLAXIS REDUCES INPATIENT RESOURCE CONSUMPTION BY BEING EFFECTIVE IN PREVENTING CYTOMEGALOVIRUS REACTIVATION AFTER ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION: A SINGLE CENTER REAL-WORLD EXPERIENCE (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1488;
Letermovir dramatically lowered the cumulative incidence of CMV reactivation to the same extent as observed in the pivotal trial. In terms of resource consumption, letermovir substantially reduced hospitalisation needs for foscarnet application enabling health care providers to allocate inpatient resources to other patients in need.
- Prevymis (letermovir) / Merck (MSD)
[VIRTUAL] CLINICAL EFFICACY OF LETERMOVIR PROPHYLAXIS FOR CMV INFECTION AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION: A SINGLE CENTER EXPERIENCE (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1480;
In terms of resource consumption, letermovir substantially reduced hospitalisation needs for foscarnet application enabling health care providers to allocate inpatient resources to other patients in need. Consistent with the phase III trial, our study shows that LET for the prophylaxis of CMV infection is safe, and considerably effective in a real-world setting.
- Prevymis (letermovir) / Merck (MSD)
[VIRTUAL] PREDICTION OF CMV REACTIVATION BY THE RECIPIENT IGG TITER BEFORE ALLO-HCT (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1476;
Recipient CMV-IgG titer should be considered in the risk stratification of CMV reactivation. Clinical Trial Registry: No clinical trial registry
- Prevymis (letermovir) / Merck (MSD)
[VIRTUAL] EFFICACY OF LETERMOVIR FOR PROPHYLAXIS OF CMV REACTIVATION AFTER ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION: A MULTI CENTER RETROSPECTIVE ANALYSIS AMONG JAPANESE PATIENTS (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1467;
Clinical Trial Registry: No clinical trial registry LTV effectively prevents or delays CMV reactivation, that possibly contributes to improve transplant outcome, although long-term follow up will be required.
- Prevymis (letermovir) / Merck (MSD)
[VIRTUAL] BASELINE CHARACTERISTICS AND EARLY POLY-FUNCTIONAL ASSESSMENT OF T CELLS TO IDENTIFY PATIENTS AT HIGHER RISK TO DEVELOP SEVERE HCMV REACTIVATION AFTER ALLOGENEIC HSCT (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1461;
Conversely to what reported by other authors, we also found a direct correlation between the amount of total and HCMV-specific CD4+/CD8+ T-cells detected one month after HSCT and the risk of HCMV reactivation requiring pre-emptive therapy. Taken together, these data suggest that poly-functional assessment of CD8+ T-cells may be used as an additional useful tool to better identify patients who will significantly benefit from anti-HCMV prophylaxis early after allo-HSCT.
- cyclophosphamide intravenous / Generic mfg.
[VIRTUAL] IMPACT OF CMV SEROSTATUS AND CMV REACTIVATION AFTER HAPLOIDENTICAL-SCT WITH PT-CY (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1445;
CMV reactivation is associated with increased risk of developing grade 2-4 acute GVHD. We conclude that also in the platform of haplo-SCT with PT-Cy, letermovir prophylaxis may be given mainly to CMV seropositive recipients, that may benefit the most in terms of CMV reactivation, acute GVHD incidence and NRM.
- Prevymis (letermovir) / Merck (MSD), cyclophosphamide intravenous / Generic mfg.
[VIRTUAL] PRIMARY LETERMOVIR PROPHYLAXIS IN CMV SEROPOSITIVE PATIENTS UNDERGOING ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION: REAL LIFE EXPERIENCE (ePoster Area) - Feb 8, 2020 - Abstract #EBMT2020EBMT_1442;
The conditioning regimen was myeloablative (MAC) in 172 patients, thiotepa fludarabine busulfan (TBF, n=155) or total body irradiation 1200 rads (TBI, n=17) and reduced intensity/toxicities regimen (RIT) in 15 patients... Our experience demonstrates the efficacy of Letermovir in a real-world setting for the prevention of clinically significant CMV infection during the first 14 weeks after allogeneic HSCT in CMV-seropositive patients, without severe adverse events.
- ||| Prevymis (letermovir) / Merck (MSD)
Letermovir for secondary prophylaxis of CMV infection and disease after allogeneic hematopoietic cell transplantation: Results from the French compassionate program #BBMT #BMTsm https://t.co/kDIDlYquQP (Twitter) - Feb 8, 2020
- | Prevymis (letermovir) / Merck (MSD)
Trial completion date, Trial primary completion date, Post-transplantation: Extension of Letermovir (LET) From Day 100 to Day 200 Post-transplant for the Prevention of Cytomegalovirus (CMV) Infection in Hematopoietic Stem Cell Transplant (HSCT) Participants (MK-8228-040) (clinicaltrials.gov) - Feb 5, 2020
P3, N=216, Recruiting, Sponsor: Merck Sharp & Dohme Corp.
Our experience demonstrates the efficacy of Letermovir in a real-world setting for the prevention of clinically significant CMV infection during the first 14 weeks after allogeneic HSCT in CMV-seropositive patients, without severe adverse events. Trial completion date: Jul 2022 --> Dec 2021 | Trial primary completion date: Jun 2022 --> Aug 2021
- Antisense inhibition of the new target lpxB gene and synergy with colistin in Acinetobacter baumannii (Arena 2) - Feb 4, 2020 - Abstract #ECCMID2020ECCMID_3543;
PNA anti-LpxB inhibits the transcription of lpxB gene, causing bacterial death, showing higher activity than PNA anti-MurA. PNA anti-LpxB and colistin showed synergy in A. baumannii strains.
- Using new tools to identify and measure healthcare-associated infections (HALL G) - Feb 4, 2020 - Abstract #ECCMID2020ECCMID_3542;
- rifampicin / Generic mfg.
Management of multidrug-resistant osteoarticular tuberculosis in France from 2007 to 2017 (HALL C) - Feb 4, 2020 - Abstract #ECCMID2020ECCMID_3541;
MDR-TB OAI is rarely described. We show that despite difficulties in follow-up, medico-surgical management allows favorable outcome.
- rifampicin / Generic mfg.
Evaluation of the efficacy of an assembly of three bacteriophages compared or associated to antibiotics on Staphylococcus aureus embedded in biofilms or internalised in osteoblasts (Arena 2) - Feb 4, 2020 - Abstract #ECCMID2020ECCMID_3540;
Ferry T et al. Open Forum Infect Dis.
- Significant change in patients' beliefs and expectations about antibiotic treatment for upper respiratory tract infection as the result of brief educational slideshows delivered immediately prior to general practice consultation (HALL N) - Feb 4, 2020 - Abstract #ECCMID2020ECCMID_3539;
Interventions that target both the prescriber and the patient are more likely to change prescriber behaviour. Figure: Degree of participant agreement with statements about antibiotic efficacy and expectations for antibiotic treatment, before and after an educational presentation.
- Clinical implications of microbiologic treatment failure in pneumonia: the pathogen matters () - Feb 4, 2020 - Abstract #ECCMID2020ECCMID_708;
Patients with pneumonia secondary to S. aureus or nonfermenting gram-negative bacilli who experienced clinical cure but microbiologic treatment failure were greater than 2 times more likely to die or develop recurrent pneumonia within 90 days following clinical cure than those with microbiologic cure. This association was not observed among patients with pneumonia secondary to other pathogens including Enterobacteriaceae.
- | Prevymis (letermovir) / Merck (MSD)
Journal: Update on prevention of cytomegalovirus in hematopoietic cell transplantation. (Pubmed Central) - Jan 31, 2020
The landscape of CMV prevention is about to change with the approval of a new anti-CMV antiviral that is safe and effective. However, the prophylaxis may lead to late onset CMVi in the context of ongoing risk factors after stopping prophylaxis and measures to counter this shifting epidemiology will need further research; such as extending the prophylaxis in high-risk patients vs. immunotherapy with vaccination and T-cell therapy.
- || Prevymis (letermovir) / Merck (MSD), tacrolimus / Generic mfg.
Clinical, PK/PD data, Journal: Pharmacokinetics of Tacrolimus Coadministered With Letermovir in Allogeneic Hematopoietic Stem Cell Transplantation Patients. (Pubmed Central) - Jan 27, 2020
However, the prophylaxis may lead to late onset CMVi in the context of ongoing risk factors after stopping prophylaxis and measures to counter this shifting epidemiology will need further research; such as extending the prophylaxis in high-risk patients vs. immunotherapy with vaccination and T-cell therapy. No abstract available
- || Prevymis (letermovir) / Merck (MSD)
Clinical, Clinical data, Journal: Pre-engraftment cytomegalovirus DNAemia in allogeneic hematopoietic stem cell transplant recipients: incidence, risk factors, and clinical outcomes. (Pubmed Central) - Jan 25, 2020
To gauge the risk of delaying initiation of prophylaxis with letermovir from the time of donor infusion to prevent CMV infection in allo-HSCT recipients we investigated the clinical outcomes of CMV DNAemia episodes occurring before engraftment, and compared to that of episodes developing after engraftment (up to day +365)...The cellular content of the donor progenitor cell infusion and transplant characteristics of patients did not differ between patients with pre-engraftment or post-engraftment CMV DNAemia. The cumulative incidence of overall mortality by days 100 and 365, aGvHD by day 100 and relapse by day 365 were not significantly different between patients with pre-engraftment or post-engraftment CMV DNAemia.
- |||| Prevymis (letermovir) / Merck (MSD)
PK/PD data: Our paper now out in @BMTjournal Lack of a significant pharmacokinetic interaction between letermovir and calcineurin inhibitors in allogeneic HCT recipients - great job by our BMT PharmDs who lead this effort @valkalbhatt #bmtsm https://t.co/QihieAbuK5 (Twitter) - Jan 16, 2020
- Prevymis (letermovir) / Merck (MSD), Actemra IV (tocilizumab) / Roche, JW Pharma
Letermovir Cytomegalovirus (CMV) Prophylaxis in Adult Seropositive Cord Blood Transplant (CBT) Recipients Is Highly Efficacious and Likely Cost-Effective (World Center Marriott - Palms & Cypress Foyers) - Jan 14, 2020 - Abstract #TCTASTCTCIBMTR2020TCT_1335;
Moreover, it has been well tolerated in CBT recipients & preliminary analysis suggests prophylaxis is cost effective. While further investigation is required, this data supports letermovir being a new standard of care in adult CBT.
- Prevymis (letermovir) / Merck (MSD), cyclophosphamide intravenous / Generic mfg.
Extended Letermovir Administration, Beyond Day 100, Is Effective for CMV Prophylaxis in Patients with Graft Versus Host Disease (World Center Marriott - Palms & Cypress Foyers) - Jan 14, 2020 - Abstract #TCTASTCTCIBMTR2020TCT_1323;
The median duration of letermovir after the diagnosis of GVHD was 5 months. 10/12 patients received letermovir beyond 100 days post-transplant.
- Prevymis (letermovir) / Merck (MSD)
Letermovir Prophylaxis in Patients at High Risk for CMV Disease Following Hematopoietic Cell Transplant (World Center Marriott - Palms & Cypress Foyers) - Jan 14, 2020 - Abstract #TCTASTCTCIBMTR2020TCT_1319;
o Compared to controls, LET prophylaxis decreased the burden of CMV. o Other analyses not shown: hospitalizations, transfusions, infections, GHVD, relapse, survival
- Prevymis (letermovir) / Merck (MSD), Cytovene (ganciclovir) / Roche
CMV Viral Load Kinetics As Surrogate Endpoints for Antiviral Prophylaxis Trials (World Center Marriott - Palms & Cypress Foyers) - Jan 14, 2020 - Abstract #TCTASTCTCIBMTR2020TCT_1298;
Introduction: The paradigm for preventing clinically significant cytomegalovirus (CMV) infection and CMV disease after hematopoietic cell transplantation (HCT) has shifted from preemptive treatment to antiviral prophylaxis with the approval of letermovir. We have shown for the first time in a clinical endpoint-rich, placebo-controlled antiviral prophylaxis trial that CMV viral load kinetics fulfill the Prentice criteria as valid surrogate endpoints and have high predictive value for CMV disease after HCT.
- Prevymis (letermovir) / Merck (MSD)
Clinical "Real-World" Experience with Letermovir for Prevention of Cytomegalovirus Infection in Allogeneic Hematopoietic Cell Transplant Recipients (World Center Marriott - Palms & Cypress Foyers) - Jan 14, 2020 - Abstract #TCTASTCTCIBMTR2020TCT_1288;
Further studies are needed to investigate the role of letermovir use beyond 100 days post-HCT. Figure 1: Post-HCT 200-day cumulative incidence of CMV DNAemia in the letermovir (n=25) and control (n=106) groups Figure 2: Post-HCT 200-day cumulative incidence of clinically significant CMV infection in the letermovir (n=25) and control (n=106) groups
- cyclophosphamide intravenous / Generic mfg., Rituxan (rituximab) / Roche, Biogen, Zenyaku Kogyo
Viral Reactivation after T Cell Replete Haploidentical Stem Cell Transplantation: Increased Incidence in Association with Immune Reconstitution (World Center Marriott - Palms & Cypress Foyers) - Jan 14, 2020 - Abstract #TCTASTCTCIBMTR2020TCT_1252;
Feasibility of haploidentical stem cell transplantation (haploSCT) is enhanced by use of post-transplant cyclophosphamide (PTCY)...CIN of EBV reactivation (>1,000 copies/ml) was 47.1% (95% CI, 34.2-63.9%) at 1 year, and preemptive therapy with rituximab was required in 2 patients...Strategies to prevent viral infection are strongly warranted. The timing and duration of such interventions (like letermovir or adoptive immunotherapy) may be guided by the tempo of immune reconstitution.
- || Prevymis (letermovir) / Merck (MSD), Noxafil (posaconazole) / Merck (MSD)
@Merck #prevymis #noxafil (Twitter) - Jan 14, 2020