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Article Abstract
Letermovir, an anti-cytomegalovirus (CMV) drug, is recommended as a prophylactic agent in patients at risk of CMV infection/reactivation after allogeneic hematopoietic stem cell transplant. We report the curative and pre-emptive use of letermovir in two heart transplant recipients. In one patient with ganciclovir-resistant CMV, letermovir was successfully used to treat CMV colitis. In the second patient, letermovir was used as pre-emptive therapy for CMV reactivation, but did not prevent CMV esophagitis. In both cases, letermovir was successful for secondary prophylaxis. Curative use of letermovir may be considered if resistance or major adverse effect of other antivirals therapy is suspected.
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Article Synopsis
- Cord blood transplantation (CBT) has a high risk of cytomegalovirus (CMV) infection, and Letermovir (LTV) is an effective drug for preventing CMV reactivation after CBT.
- A study involving 79 adult patients revealed that those who received LTV had significantly lower rates of CMV reactivation compared to those who did not, with 11.1% versus 82.4% at day 100 and 45.3% versus 82.4% at one year.
- Despite the lower reactivation rates, approximately 34.2% of patients experienced late CMV reactivation after stopping LTV, suggesting the need for ongoing monitoring and potential extension of LTV use
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