Article
Hematology
Danniel Zamora, Elizabeth R. Duke, Hu Xie, Bradley C. Edmison, Brenda Akoto, Richard Kiener, Terry Stevens-Ayers, Ralf Wagner, Marco Mielcarek, Wendy M. Leisenring, Keith R. Jerome, Joshua T. Schiffer, Greg Finak, Stephen C. De Rosa, Michael Boeckh
Summary: The study suggests that letermovir may delay CMV-specific cellular reconstitution, possibly due to decreased CMV antigen exposure. Evaluating T-cell polyfunctionality can help identify patients at risk for late CMV infection after HCT.
Article
Microbiology
Marta Santos Bravo, Valentin Tilloy, Nicolas Plault, Sonsoles Sanchez Palomino, Maria Mar Mosquera, Mireia Navarro Gabriel, Francesc Fernandez Aviles, Maria Suarez Lledo, Montserrat Rovira, Asuncion Moreno, Laura Linares, Marta Bodro, Sebastien Hantz, Sophie Alain, Maria Angeles Marcos
Summary: We provide comprehensive data on the clinical correlates of both CMV genotypic follow-up by standard and deep sequencing and the clinical outcomes, as well as recombinant phenotypic results of this novel mutation. Our study emphasizes the importance of clinical follow-up in combination with genotypic and phenotypic studies for the assessment and optimization of patients experiencing HCMV relapses or not responding to antiviral therapy. This information may be important for other researchers and clinicians working in the field to improve the care of transplant patients since drug-resistant CMV infections are an important emerging problem even with the new antiviral development.
MICROBIOLOGY SPECTRUM
(2022)
Article
Medicine, Research & Experimental
Susan E. Prockop, Aisha Hasan, Ekaterina Doubrovina, Parastoo B. Dahi, Irene Rodriguez-Sanchez, Michael Curry, Audrey Mauguen, Genovefa A. Papanicolaou, Yiqi Su, JinJuan Yao, Maria Arcila, Farid Boulad, Hugo Castro-Malaspina, Christina Cho, Kevin J. Curran, Sergio Giralt, Nancy A. Kernan, Guenther Koehne, Ann Jakubowski, Esperanza Papadopoulos, Miguel-Angel Perales, Ioannis Politikos, Keith Price, Annamalai Selvakumar, Craig S. Sauter, Roni Tamari, Teresa Vizconde, James W. Young, Richard J. O'Reilly
Summary: The adoptive transfer of CMVpp65-sensitized T cells from a third-party donor can improve the prognosis for recipients of hematopoietic stem cell transplant with refractory CMV viremia and disease, providing potential new treatments for these patients.
JOURNAL OF CLINICAL INVESTIGATION
(2023)
Article
Immunology
Yiqi Su, Anat Stern, Eleni Karantoni, Tamara Nawar, Gyuri Han, Phaedon Zavras, Henry Dumke, Christina Cho, Roni Tamari, Brian Shaffer, Sergio Giralt, Ann Jakubowski, Miguel-Angel Perales, Genovefa Papanicolaou
Summary: The study found that letermovir prophylaxis (LET) can reduce the mortality disparity between cytomegalovirus-negative and positive hematopoietic cell transplant (HCT) recipients at 1 year after transplantation. Among all cytomegalovirus-positive recipients, LET is associated with decreased mortality, especially in T-cell depleted HCT.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Oncology
Delaney Wolfe, Qiuhong Zhao, Emma Siegel, Marcin Puto, Danielle Murphy, Julianna Roddy, Yvonne Efebera, Justin Tossey
Summary: Patients with GVHD who received letermovir prophylaxis had significantly fewer CMV infections, reduced non-relapsed mortality, and improved overall survival, suggesting that letermovir prophylaxis improves outcomes in this high-risk population.
Article
Immunology
Anat Stern, Yiqi Su, Henry Dumke, Jiaqi Fang, Roni Tamari, Ann Jakubowski, Christina Cho, Sergio Giralt, Miguel-Angel Perales, Genovefa A. Papanicolaou
Summary: This study investigated the association between time-averaged area under the curve (AAUC) of CMV viral load and overall survival at 1-year post-HCT. Results showed that non-controllers had worse survival rates, while controllers had similar outcomes to elite-controllers or R-/D-. Further research is needed to validate the AAUC cutoff across different cohorts and CMV management strategies.
JOURNAL OF INFECTIOUS DISEASES
(2021)
Article
Immunology
Vera Portillo, Stavroula Masouridi-Levrat, Lena Royston, Sabine Yerly, Manuel Schibler, Maria Mappoura, Sarah Morin, Federica Giannotti, Anne-Claire Mamez, Christian van Delden, Yves Chalandon, Dionysios Neofytos
Summary: Positive CMV serology in allogeneic hematopoietic cell transplant recipients (allo-HCTRs) may be false-positive due to transfusion-associated passive immunity. Reclassifying CMV status can help accurately assess the risk of CMV infection in these patients.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Immunology
Lena Royston, Eva Royston, Stavroula Masouridi-Levrat, Nathalie Vernaz, Yves Chalandon, Christian Van Delden, Dionysios Neofytos
Summary: The study demonstrated that primary anti-CMV letermovir prophylaxis significantly reduced the incidence of CMV infection in high-risk patients after HCT, decreasing the need for treatment and associated costs. Letermovir also showed positive effects on platelet reconstitution and renal function.
Article
Immunology
Hannah N. Imlay, Daniel R. Kaul
Summary: Until recently, available drugs for CMV prevention and treatment in transplant patients have been limited by toxicity and resistance issues, with letermovir being the first new drug approved for CMV prevention since 2003. The efficacy of letermovir in treating established CMV infection or disease remains largely unstudied, while the investigational agent maribavir shows promise as a preemptive treatment option with unique mechanisms of action. Ongoing studies will define the efficacy of these drugs in patients with refractory or resistant CMV disease.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Microbiology
Lena Royston, Stavroula Masouridi-Levrat, Verena Gotta, Eva Royston, Caroline Pressacco-Brossier, Yasmine Abi Aad, David Tonoli, Abderrahim Karmime, Murielle Jayo, Christian Van Delden, Pierre Lescuyer, Marc Pfister, Yves Chalandon, Dionysios Neofytos
Summary: This study evaluated the efficacy and safety of letermovir, an anti-cytomegalovirus drug, in hematopoietic stem cell transplant recipients. The results showed that the blood concentration of letermovir remained stable during treatment, but had no noticeable associations with clinical efficacy. The study also found potential associations between concomitantly administered drugs and adverse events, highlighting the need for further research.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2022)
Review
Virology
Carlos Solano, Estela Gimenez, Eliseo Albert, Jose L. Pinana, David Navarro
Summary: Letermovir has been approved by the US FDA for prophylaxis of CMV infection in adult allogeneic stem cell transplant recipients. Real-world experience has validated the clinical trial results, showing that it significantly reduces the risk of CMV infection and improves survival. However, further investigation is needed to address issues such as viral load threshold, impact on CMV-specific T-cell responses, and prevention of LMV-resistant strains.
JOURNAL OF MEDICAL VIROLOGY
(2023)
Article
Hematology
Amanda M. Casto, Sachiko Seo, David M. Levine, Barry E. Storer, Xinyuan Dong, John A. Hansen, Michael Boeckh, Paul J. Martin
Summary: This study found that only the donor ABCB1 gene variant was associated with CMV reactivation after allogeneic hematopoietic cell transplantation. Other genetic variants previously linked to CMV phenotypes did not significantly alter the risk for CMV reactivation or disease post-transplant.
Article
Immunology
Alicja Sadowska-Klasa, Wendy M. Leisenring, Ajit P. Limaye, Michael Boeckh
Summary: A systematic review of randomized and observational studies from 2013-2023 indicated that antiviral preemptive therapy initiated at cytomegalovirus viral load thresholds between 2 and 3 log10 IU/mL had comparable cytomegalovirus disease rates. Thus, viral thresholds within this range appeared to effectively safeguard patients who did not receive prophylaxis.
JOURNAL OF INFECTIOUS DISEASES
(2023)
Article
Biophysics
Yasuo Mori, Fumiaki Jinnouchi, Katsuto Takenaka, Takatoshi Aoki, Takuro Kuriyama, Masanori Kadowaki, Jun Odawara, Toshiyuki Ueno, Kentaro Kohno, Takuya Harada, Goichi Yoshimoto, Ken Takase, Hideho Henzan, Koji Kato, Yoshikiyo Ito, Tomohiko Kamimura, Yuju Ohno, Ryosuke Ogawa, Tetsuya Eto, Koji Nagafuji, Koichi Akashi, Toshihiro Miyamoto
Summary: Prophylactic treatment with LMV significantly reduces the incidence of csCMV infection, delays the initiation of preemptive therapy, shortens the duration of treatment, and improves overall survival rates after transplantation.
BONE MARROW TRANSPLANTATION
(2021)
Article
Medicine, General & Internal
Ajit P. Limaye, Klemens Budde, Atul Humar, Flavio Vincenti, Dirk R. J. Kuypers, Robert P. Carroll, Nicole Stauffer, Yoshihiko Murata, Julie M. Strizki, Valerie L. Teal, Christopher L. Gilbert, Barbara A. Haber
Summary: This study compared the efficacy and safety of letermovir with valganciclovir in preventing cytomegalovirus (CMV) disease in kidney transplant recipients. Results showed that letermovir was as effective as valganciclovir in preventing CMV disease over 52 weeks, with lower rates of leukopenia or neutropenia, supporting its use for this indication.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Immunology
Georgios Angelidakis, Fareed Khawaja, Victor E. Mulanovich, Natalie Dailey-Garnes, Ella Ariza-Heredia, Roy F. Chemaly
Summary: This study reports on two hematopoietic cell transplant recipients with severe influenza infections who were treated with a combination of baloxavir and oseltamivir. The study discusses possible reasons for their different responses.
MICROBES AND INFECTION
(2022)
Letter
Critical Care Medicine
Emily A. Siegrist, Joseph Sassine
INTENSIVE CARE MEDICINE
(2022)
Article
Public, Environmental & Occupational Health
Fareed Khawaja, Krithika Srinivasan, Amy Spallone, Adina Feldman, Sherry Cantu, Ella Ariza-Heredia, Tanya Dvordak, Amin Alousi, Sairah Ahmed, Marina George, Elizabeth Frenzel, Micah Bhatti, Roy F. Chemaly
Summary: This article describes the early experience with nosocomial respiratory viral infections (RVIs) at a cancer center in the first year of the pandemic. The investigation revealed that nosocomial transmission of COVID-19 most likely occurred from employees to patients. The severity of viral infections led to enhancement of infection control measures, and the impact of COVID-19 vaccination on infection control policies requires further study.
AMERICAN JOURNAL OF INFECTION CONTROL
(2023)
Review
Immunology
Emily A. Siegrist, Joseph Sassine
Summary: This review provides an overview of the basic pharmacology, animal data, and human data for three antivirals (cidofovir, brincidofovir, and tecovirimat) with activity against monkeypox virus. These antiviral agents have shown varying degrees of efficacy against monkeypox and other orthopoxviruses, highlighting their potential importance in the research and treatment of monkeypox virus infection.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Respiratory System
Christopher D. Bertini Jr, Fareed Khawaja, Ajay Sheshadri
Summary: COVID-19 often leads to more severe infections in immunocompromised patients, especially those with hematologic malignancies, SOT recipients, and patients with ARD, resulting in higher hospitalization, disease severity, and mortality rates. Treatment approaches for these patients are similar to immunocompetent individuals, but lack high-quality data. Vaccinations are recommended but less effective in immunocompromised patients. It is crucial for the medical and scientific communities to focus on the vulnerability of immunocompromised patients during the ongoing pandemic. Research focusing on this population will provide valuable insights into mitigating harms in these high-risk individuals.
CLINICS IN CHEST MEDICINE
(2023)
Letter
Gastroenterology & Hepatology
Chia-Yu Chiu, Krina Patel, Sheeba K. Thomas, Fareed Khawaja, Natalie J. M. Dailey Garnes, Hans C. Lee, Maro Ohanian, Ying Jiang, Lan S. Wang, Jessica P. Hwang, Harrys A. Torres
HEPATOLOGY INTERNATIONAL
(2023)
Article
Biology
Hiba Dagher, Anne-Marie Chaftari, Ishwaria M. Subbiah, Alexandre E. Malek, Ying Jiang, Peter Lamie, Bruno Granwehr, Teny John, Eduardo Yepez, Jovan Borjan, Cielito Reyes-Gibby, Mary Flores, Fareed Khawaja, Mala Pande, Noman Ali, Raniv Rojo, Daniel D. Karp, Patrick Chaftari, Ray Hachem, Issam I. Raad
Summary: This study aims to assess the post-acute sequelae of SARS-CoV-2 infection (PASC) in cancer patients following acute COVID-19 recovery. The study found that over half of cancer patients continue to experience long-term COVID-19 symptoms after recovery, with the most common symptoms being fatigue, sleep disturbances, myalgias, and gastrointestinal symptoms. Most of the patients were managed on an outpatient basis, with only 8.5% requiring readmission for COVID-19-related reasons.
Article
Biology
Issam I. Raad, Ray Hachem, Nigo Masayuki, Tarcila Datoguia, Hiba Dagher, Ying Jiang, Vivek Subbiah, Bilal Siddiqui, Arnaud Bayle, Robert Somer, Ana Fernandez Cruz, Edward Gorak, Arvinder Bhinder, Nobuyoshi Mori, Nelson Hamerschlak, Samuel Shelanski, Tomislav Dragovich, Yee Elise Vong Kiat, Suha Fakhreddine, Abi Hanna Pierre, Roy F. Chemaly, Victor Mulanovich, Javier Adachi, Jovan Borjan, Fareed Khawaja, Bruno Granwehr, Teny John, Eduardo Yepez Yepez, Harrys A. Torres, Natraj Reddy Ammakkanavar, Marcel Yibirin, Cielito C. Reyes-Gibby, Mala Pande, Noman Ali, Raniv Dawey Rojo, Shahnoor M. Ali, Rita E. Deeba, Patrick Chaftari, Takahiro Matsuo, Kazuhiro Ishikawa, Ryo Hasegawa, Ramon Aguado-Noya, Alvaro Garcia Garcia, Cristina Traseira Puchol, Dong Gun Lee, Monica Slavin, Benjamin Teh, Cesar A. Arias, Dimitrios P. Kontoyiannis, Alexandre E. Malek, Anne-Marie Chaftari
Summary: This international multicenter study aimed to identify independent risk factors for increased 30-day mortality in COVID-19 patients with and without cancer. The study analyzed data from 16 international centers and found that cancer itself was not an independent risk factor for increased mortality. Older age and lymphopenia were the main predictors of 30-day mortality in all patients, and remdesivir was the only therapeutic agent associated with decreased mortality.
Article
Oncology
Chia-Yu Chiu, Sairah Ahmed, Sheeba K. Thomas, Lan Sun Wang, Khalis Mustafayev, Luis E. Fayad, William G. Wierda, Fareed Khawaja, Harrys A. Torres
Summary: A retrospective analysis found that HBV reactivation occurred in 3 out of 29 patients receiving BTK inhibitors, indicating the need for monitoring in this scenario. The risk of HBV reactivation is intermediate in patients with past HBV infection who receive BTK inhibitors. Universal anti-HBV prophylaxis is not recommended, but monitoring for HBV reactivation is warranted in patients with past HBV infection receiving BTK inhibitors.
CLINICAL LYMPHOMA MYELOMA & LEUKEMIA
(2023)
Article
Oncology
Mehmet Altan, Felipe Soto, Linda L. Zhong, Fechukwu O. Akhmedzhanov, Nathaniel R. Wilson, Abdulrazzak Zarifa, Aya A. Albittar, Vincent Yang, Jeff Lewis, Waree Rinsurongkawong, J. Jack Lee, Vadeerat Rinsurongkawong, Jianjun Zhang, Don L. Gibbons, Ara A. Vaporciyan, Kristofer Jennings, Fareed Khawaja, Saadia A. Faiz, Vickie R. Shannon, Girish Shroff, Myrna C. B. Godoy, Naval G. Daver, Saumil Gandhi, Tito R. Mendoza, Aung Naing, Carrie Daniel-MacDougall, John Heymach, Ajay Sheshadri
Summary: This study retrospectively analyzed 419 patients with advanced non-small cell lung cancer who received immune checkpoint inhibitor therapy and found a high incidence of pneumonitis, which significantly increased the risk of death. The risk of pneumonitis was higher in patients without a smoking history and patients with interstitial lung disease.
Editorial Material
Immunology
Emily A. Siegrist, Cody Thomas, Mohamad Khawandanah, Joseph Sassine
TRANSPLANT INFECTIOUS DISEASE
(2023)
Editorial Material
Pharmacology & Pharmacy
Emily A. Siegrist, Joseph Sassine
EXPERT REVIEW OF CLINICAL PHARMACOLOGY
(2023)
Article
Infectious Diseases
Elaine Liu, Andrea M. Prinzi, Jovan Borjan, Samuel L. Aitken, Patricia A. Bradford, William F. Wright
Summary: Antimicrobial resistance (AMR) is a global health crisis. Clinicians face challenges in treating patients with antimicrobial-resistant infections. A strong understanding of clinical microbiology, infectious diseases, and pharmacology can help clinicians navigate these cases. Important factors include laboratory testing, understanding pathogen resistance, recognizing resistance trends, identifying acquired AMR mechanisms, and considering these factors for an optimal pharmacological plan. This article outlines a novel framework for approaching clinical AMR, encourages education on AMR, and improves therapeutic decision-making in AMR-related illnesses.
JAC-ANTIMICROBIAL RESISTANCE
(2023)
Article
Oncology
Fareed Khawaja, Marilyne Daher, Amy Spallone, Roy F. Chemaly
Summary: COVID-19 disproportionately affects cancer patients due to their weakened immune systems. Vaccination is a strategy to mitigate the impact, offering some level of protection against severe complications like respiratory failure and death, with limited safety concerns. This review discusses available COVID-19 vaccines, their efficacy and safety in cancer patients, current vaccination guidelines, and future directions.
Article
Hematology
Fareed Khawaja, Genovefa Papanicolaou, Sanjeet Dadwal, Steven A. Pergam, John R. Wingard, Zeinab El Boghdadly, Maheen Z. Abidi, Alpana Waghmare, Zainab Shahid, Laura Michaels, Joshua A. Hill, Mini Kamboj, Michael Boeckh, Jeffery J. Auletta, Roy F. Chemaly
Summary: COVID-19 disproportionately affects immunocompromised and elderly patients. Hematopoietic cell transplantation and CAR T-cell recipients may have suboptimal immune response to COVID-19 vaccines. Guidelines for optimizing vaccine use in these patients are provided by professional societies.
TRANSPLANTATION AND CELLULAR THERAPY
(2023)