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Treatment of CMV infection after allogeneic hematopoietic stem cell transplantation
- Source :
- Expert Review of Hematology. 9:585-596
- Publication Year :
- 2016
- Publisher :
- Informa UK Limited, 2016.
-
Abstract
- Despite a remarkable reduction in the past decades, cytomegalovirus (CMV) disease in allogeneic hematopoietic stem cell transplant (HSCT) recipients remains a feared complication, still associated with significant morbidity and mortality. Today, first line treatment of CMV infection/reactivation is still based on dated antiviral compounds Ganciclovir (GCV), Foscarnet (FOS) and Cidofovir (CDF) with their burdensome weight of side effects. Maribavir (MBV), Letermovir (LMV) and Brincidofovir (BDF) are three new promising anti-CMV drugs without myelosuppressive properties or renal toxic effects that are under investigation in randomized phase II and III trials. Adoptive T-cell therapy (ATCT) in CMV infection possesses a strong rationale, demonstrated by several proof of concept studies; its feasibility is currently under investigation by clinical trials. ATCT from third-party and naïve donors could meet the needs of HSCT recipients of seronegative donors and cord blood grafts. In selected patients such as recipients of T-cell depleted grafts, ATCT, based on CMV-specific host T-cells reconstitution kinetics, would be of value in the prophylactic and/or preemptive CMV treatment. Vaccine-immunotherapy has the difficult task to reduce the incidence of CMV reactivation/infection in highly immunocompromised HSCT patients. Newer notions on CMV biology may represent the base to flush out the Troll of transplantation.
- Subjects :
- 0301 basic medicine
Ganciclovir
Foscarnet
T-Lymphocytes
medicine.medical_treatment
Brincidofovir
Hematopoietic stem cell transplantation
Antiviral Agents
Immunotherapy, Adoptive
immune response
Cytomegalovirus Vaccines
03 medical and health sciences
chemistry.chemical_compound
Letermovir
Drug Resistance, Viral
medicine
Animals
Humans
Transplantation, Homologous
business.industry
Hematopoietic Stem Cell Transplantation
virus diseases
hematopoietic stem cell transplantation (HSCT)
Maribavir
CMV-vaccine
Hematology
Cytomegalovirus (CMV)
adoptive T-cell therapy (ATCT)
Transplantation
Treatment Outcome
030104 developmental biology
chemistry
Cytomegalovirus Infections
Immunology
business
medicine.drug
Cidofovir
Subjects
Details
- ISSN :
- 17474094 and 17474086
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Expert Review of Hematology
- Accession number :
- edsair.doi.dedup.....6c2da47a6270436534f8e767f5ca2509