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Association between early anti-cytomegalovirus therapy and the incidence of chronic graft-versus-host disease. | LitMetric

AI Article Synopsis

  • Ganciclovir and foscarnet are two anti-CMV medications, with a previous study suggesting foscarnet lowers chronic graft-versus-host disease (GVHD) risk.
  • A nationwide study of nearly 8,900 patients revealed that those on ganciclovir faced higher risks of chronic and extensive chronic GVHD compared to those on foscarnet.
  • Particularly among male patients with female donors, foscarnet recipients had a significantly lower incidence of extensive chronic GVHD three years post-transplant, suggesting it may positively influence alloimmunization.

Article Abstract

Ganciclovir and foscarnet are two representative anti-cytomegalovirus (CMV) agents. A previous regional study revealed a lower risk of chronic graft-versus-host disease (GVHD) in patients who received pre-emptive foscarnet. We conducted a retrospective nationwide study to confirm the results. A total of 8890 patients aged 16 or older with hematological malignancies who received foscarnet (n = 1555) or ganciclovir (n = 7335) during their first hematopoietic stem cell transplantation (HSCT) were included. The risks of chronic GVHD (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.13-1.40; P < 0.001) and extensive chronic GVHD (HR, 1.16; 95% CI, 1.01-1.33; P = 0.033) were higher with ganciclovir. Among male patients with a female donor, the incidence of extensive chronic GVHD 3 years after HSCT was clearly lower with foscarnet (13%; 95% CI, 9-16%) than with ganciclovir (27%; 95% CI, 25-29%; P < 0.001). In male patients who received HSCT from female donors, foscarnet recipients showed significantly lower incidence of extensive chronic GVHD than ganciclovir recipients, regardless of donor source or previous acute GVHD. While caution is necessary, these results indicate that foscarnet affects alloimmunization and might reduce the incidence of chronic GVHD.

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Source
http://dx.doi.org/10.1007/s12185-024-03871-4DOI Listing

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