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)
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
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)
Article
Immunology
Joseph Sassine, Fareed Khawaja, Terri Lynn Shigle, Victoria Handy, Farnaz Foolad, Samuel L. Aitken, Ying Jiang, Richard Champlin, Elizabeth Shpall, Katy Rezvani, Ella J. Ariza-Heredia, Roy F. Chemaly
Summary: Primary prophylaxis with letermovir in CMV-seropositive allogeneic HCT recipients is associated with significant reductions in refractory or resistant CMV infections, nonrelapse mortality at week 48, as well as CS-CMVi and CMV end-organ disease. This approach effectively prevents difficult-to-treat CMV infections and improves outcomes after allogeneic HCT.
CLINICAL INFECTIOUS DISEASES
(2021)
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
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
Virology
Andrea Gilioli, Andrea Messerotti, Paola Bresciani, Angela Cuoghi, Valeria Pioli, Corrado Colasante, Francesca Bettelli, Davide Giusti, Fabio Forghieri, Leonardo Potenza, Francesca Donatelli, Rachele Giubbolini, Laura Galassi, Roberto Marasca, Federico Banchelli, Roberto D'Amico, Monica Pecorari, William Gennari, Tommaso Trenti, Patrizia Comoli, Mario Luppi, Franco Narni
Summary: The study retrospectively analyzed a cohort of patients who underwent HSCT and found that CMV clinically significant infection (CS-CMVi) occurred in 48% of prophylactically treated patients, but it did not impact relapse incidence or overall survival. Additionally, the use of CMV-IG alone as prophylactic therapy did not effectively prevent CMV reactivation.
JOURNAL OF MEDICAL VIROLOGY
(2021)
Article
Immunology
Lara Chavaz, Lena Royston, Stavroula Masouridi-Levrat, Anne-Claire Mamez, Federica Giannotti, Sarah Morin, Christian Van Delden, Yves Chalandon, Dionysios Neofytos
Summary: In this single-center study, we found a 23% incidence of clinically significant CMV infection during the first 100 days after discontinuation of letermovir prophylaxis in 61 allogeneic HCT recipients. This infection mainly occurred in haploidentical HCT recipients and was not associated with CMV-DNAemia under letermovir.
OPEN FORUM INFECTIOUS DISEASES
(2023)
Article
Immunology
Estela Gimenez, Manuel Guerreiro, Ignacio Torres, Cristobal Aguilar, Eliseo Albert, Juan Carlos Hernandez-Boluda, Rafael Hernani, Ariadna Perez, Paula Amat, Jose Luis Pinana, Juan Montoro, Carlos Solano, David Navarro
Summary: There is limited information on the natural kinetics of CMV DNAemia and CMV-specific T-cell reconstitution in allo-HSCT recipients undergoing LMV prophylaxis. This study found that CMV DNAemia cleared spontaneously in a high proportion of LMV patients, and LMV patients had a lower degree of CMV-specific T-cell reconstitution compared to non-LMV patients.
TRANSPLANT INFECTIOUS DISEASE
(2023)
Article
Infectious Diseases
Angela Chiereghin, Tamara Belotti, Eva Caterina Borgatti, Nicola Fraccascia, Giulia Piccirilli, Maura Fois, Michele Borghi, Gabriele Turello, Liliana Gabrielli, Riccardo Masetti, Arcangelo Prete, Stefano Fanti, Tiziana Lazzarotto
Summary: This case report demonstrates the off-label use of letermovir as preemptive antiviral therapy in a pediatric patient with drug-resistant CMV infection, showing good tolerability and effectiveness in suppression of viral replication.
INFECTION AND DRUG RESISTANCE
(2021)
Article
Immunology
Lena Royston, Eva Royston, Stavroula Masouridi-Levrat, Yves Chalandon, Christian Van Delden, Dionysios Neofytos
Summary: In allogeneic hematopoietic cell transplant recipients, low-level CMV replication and acute gastrointestinal graft-versus-host disease are significant risk factors for breakthrough clinically significant CMV infection during letermovir prophylaxis. These findings highlight the importance of closer CMV monitoring and prompt preemptive treatment by clinicians.
IMMUNITY INFLAMMATION AND DISEASE
(2021)
Article
Hematology
Joshua A. Hill, Danniel Zamora, Hu Xie, Laurel A. Thur, Colleen Delaney, Ann Dahlberg, Steven A. Pergam, Wendy M. Leisenring, Michael Boeckh, Filippo Milano
Summary: Letermovir is effective in preventing clinically significant CMV infection after CBT, but there is a higher incidence of delayed-onset infections after discontinuation, requiring close monitoring and consideration for extended prophylaxis.
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
Infectious Diseases
Eleftheria Kampouri, Danniel Zamora, Erika S. Kiem, Winnie Liu, Sarah Ibrahimi, Rachel L. Blazevic, Erika A. Lovas, Louise E. Kimball, Meei-Li Huang, Keith R. Jerome, Masumi Ueda Oshima, Marco Mielcarek, Danielle M. Zerr, Michael J. Boeckh, Elizabeth M. Krantz, Joshua A. Hill
Summary: The use of letermovir for cytomegalovirus (CMV) prophylaxis has led to a decrease in broad-spectrum anti-CMV therapy. However, the impact of letermovir on human herpesvirus-6 (HHV-6) epidemiology remains unknown. This retrospective cohort study aimed to assess changes in HHV-6 detection and disease after the routine use of prophylactic letermovir in CMV-seropositive allogeneic hematopoietic cell transplant recipients.
CLINICAL MICROBIOLOGY AND INFECTION
(2023)
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.
Letter
Immunology
Anat Stern, Leonard Leibovici, Mical Paul
CLINICAL INFECTIOUS DISEASES
(2018)
Article
Immunology
Dafna Yahav, Erica Franceschini, Fidi Koppel, Adi Turjeman, Tanya Babich, Roni Bitterman, Ami Neuberger, Nesrin Ghanem-Zoubi, Antonella Santoro, Noa Eliakim-Raz, Barak Pertzov, Tali Steinmetz, Anat Stern, Yaakov Dickstein, Elias Maroun, Hiba Zayyad, Jihad Bishara, Danny Alon, Yonatan Edel, Elad Goldberg, Claudia Venturelli, Cristina Mussini, Leonard Leibovici, Mical Paul
CLINICAL INFECTIOUS DISEASES
(2019)
Editorial Material
Immunology
Roni Bitterman, Emilia Hardak, Marina Raines, Anat Stern, Tzila Zuckerman, Yishai Ofran, Noa Lavi, Luda Guralnik, Avraham Frisch, Olga Nudelman, Mical Paul, Ilana Oren
CLINICAL INFECTIOUS DISEASES
(2019)
Review
Infectious Diseases
Anat Stern, Genovefa A. Papanicolaou
CURRENT INFECTIOUS DISEASE REPORTS
(2019)
Article
Hematology
Anat Stern, Yiqi Su, Yeon Joo Lee, Susan Seo, Brian Shaffer, Roni Tamari, Boglarka Gyurkocza, Juliet Barker, Yael Bogler, Sergio Giralt, Miguel-Angel Perales, Genovefa A. Papanicolaou
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
(2020)
Article
Hematology
Phaedon Zavras, Yiqi Su, Jiaqi Fang, Anat Stern, Nitasha Gupta, Yuexin Tang, Amit Raval, Sergio Giralt, Miguel Angel Perales, Ann A. Jakubowski, Genovefa A. Papanicolaou
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
(2020)
Article
Hematology
Jiaqi Fang, Yiqi Su, Phaedon D. Zavras, Amit D. Raval, Yuexin Tang, Miguel-Angel Perales, Sergio Giralt, Anat Stern, Genovefa A. Papanicolaou
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
(2020)
Review
Hematology
Ivan Gur, Amir Giladi, Yonathan Nachum Isenberg, Ami Neuberger, Anat Stern
Summary: Patients with hematologic malignancies (HM) are at increased risk of severe and prolonged COVID-19 due to impaired immune function and cytokine release syndrome, highlighting the importance of understanding immunopathology and exploring new treatments for this population.
ACTA HAEMATOLOGICA
(2022)
Article
Hematology
Eleni Karantoni, Phaedon D. Zavras, Yiqi Su, Jiaqi Fang, Roni Tamari, Christina Cho, Miguel-Angel Perales, Anat Stern, Genovefa A. Papanicolaou
Summary: Refractory CMV infection is associated with increased mortality and healthcare resource utilization after hematopoietic cell transplantation. Improved therapies have the potential to improve outcomes and reduce resource utilization.
TRANSPLANTATION AND CELLULAR THERAPY
(2022)
Article
Hematology
Haneen Daoud-Asfour, Israel Henig, Itai Ghersin, Stav Rakedzon, Anat Stern, Milena Pitashny, Tsila Zuckerman, Haggai Bar-Yoseph
Summary: The impact of omitting prophylactic ciprofloxacin during allo-HSCT on lower GI GVHD rate, microbiome composition, and other clinical outcomes was assessed. The study found that omitting prophylactic ciprofloxacin did not significantly affect the outcomes, suggesting further evaluation of the use of prophylactic antibiotics in this setting.
TRANSPLANTATION AND CELLULAR THERAPY
(2022)
Article
Infectious Diseases
Anat Stern, Carolyn D. Alonso, Carolina Garcia-Vidal, Celia Cardozo, Monica Slavin, Michelle K. Yong, Su Ann Ho, Seema Mehta Steinke, Robin K. Avery, Philipp Koehler, Christof Scheid, Oliver A. Cornely, Johan Maertens, Yasmine Abi Aad, David J. Epstein, Genovefa A. Papanicolaou, Dionysios Neofytos
Summary: This study evaluated the safety and efficacy of cidofovir in treating double-stranded DNA viral infections following allogeneic haematopoietic cell transplant. One-fourth of patients developed reversible nephrotoxicity during treatment. Careful patient selection and close monitoring of renal function can help minimize toxicity.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2021)
Article
Microbiology
Jannik Stemler, Caroline Bruns, Sibylle C. Mellinghoff, Nael Alakel, Hamdi Akan, Michelle Ananda-Rajah, Jutta Auberger, Peter Bojko, Pranatharthi H. Chandrasekar, Methee Chayakulkeeree, Jose A. Cozzi, Elizabeth A. de Kort, Andreas H. Groll, Christopher H. Heath, Larissa Henze, Marcos Hernandez Jimenez, Souha S. Kanj, Nina Khanna, Michael Koldehoff, Dong-Gun Lee, Alina Mager, Francesco Marchesi, Rodrigo Martino-Bufarull, Marcio Nucci, Jarmo Oksi, Livio Pagano, Bob Phillips, Juergen Prattes, Athina Pyrpasopoulou, Werner Rabitsch, Enrico Schalk, Martin Schmidt-Hieber, Neeraj Sidharthan, Pere Soler-Palacin, Anat Stern, Barbora Weinbergerova, Aline El Zakhem, Oliver A. Cornely, Philipp Koehler
Review
Medicine, General & Internal
Anat Stern, Elena Carrara, Roni Bitterman, Dafna Yahav, Leonard Leibovici, Mical Paul
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2019)
Review
Medicine, General & Internal
Anat Stern, Keren Skalsky, Tomer Avni, Elena Carrara, Leonard Leibovici, Mical Paul
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2017)