Off-Label Use of Letermovir as Preemptive Anti-Cytomegalovirus Therapy in a Pediatric Allogeneic Peripheral Blood Stem Cell Transplant.

GCV-resistant CMV intolerance to FOS off-label letermovir use pediatric allogeneic peripheral blood stem cell transplant

Journal

Infection and drug resistance
ISSN: 1178-6973
Titre abrégé: Infect Drug Resist
Pays: New Zealand
ID NLM: 101550216

Informations de publication

Date de publication:
2021
Historique:
received: 12 12 2020
accepted: 19 02 2021
entrez: 1 4 2021
pubmed: 2 4 2021
medline: 2 4 2021
Statut: epublish

Résumé

Despite the effectiveness of the currently available antiviral drugs in treating cytomegalovirus (CMV) infection, high rates of adverse effects are associated with their use. Moreover, a problem of increasing importance is the emergence of drug-resistant CMV infection. Here, we describe the first case of off-label use of letermovir (LMV) as preemptive antiviral therapy, in a pediatric allogeneic peripheral blood stem cell transplant recipient with ganciclovir-resistant CMV infection who was intolerant to foscarnet and unable to achieve viral clearance after seven doses of cidofovir. After the administration of LMV, a gradual reduction in viral load was observed and within 6 weeks of LMV treatment, after more than 6 months of positive CMV-DNAemia, the patient cleared the infection. No adverse effects associated with LMV were observed during treatment. In this pediatric study case, the off-label use of LMV for the treatment of CMV infection has been well tolerated and proved to be effective in leading to the suppression of viral replication.

Identifiants

pubmed: 33790588
doi: 10.2147/IDR.S296927
pii: 296927
pmc: PMC8001039
doi:

Types de publication

Case Reports

Langues

eng

Pagination

1185-1190

Informations de copyright

© 2021 Chiereghin et al.

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest for this work.

Références

Antimicrob Agents Chemother. 2019 Feb 26;63(3):
pubmed: 30642941
Bone Marrow Transplant. 2007 Jul;40(1):55-61
pubmed: 17468776
J Pediatric Infect Dis Soc. 2020 Sep 17;9(4):486-489
pubmed: 31362308
Curr Hematol Malig Rep. 2020 Apr;15(2):90-102
pubmed: 31981100
Antiviral Res. 2019 Jan;161:116-124
pubmed: 30472161
Clin Infect Dis. 2020 Apr 10;70(8):1525-1533
pubmed: 31179485
Lancet Infect Dis. 2019 Aug;19(8):e260-e272
pubmed: 31153807
Am J Transplant. 2018 Dec;18(12):3060-3064
pubmed: 30286286
Biol Blood Marrow Transplant. 2010 Sep;16(9):1309-14
pubmed: 20353832
World J Clin Cases. 2015 Dec 16;3(12):973-9
pubmed: 26677445
Front Microbiol. 2019 May 28;10:1186
pubmed: 31191499
N Engl J Med. 2017 Dec 21;377(25):2433-2444
pubmed: 29211658
Biol Blood Marrow Transplant. 2020 May;26(5):978-984
pubmed: 32035273
Am J Transplant. 2011 May;11(5):1079-84
pubmed: 21521474
Haematologica. 2016 Jul;101(7):803-11
pubmed: 27365460
Transplantation. 2020 Feb;104(2):404-409
pubmed: 32000236
Comput Struct Biotechnol J. 2015 Feb 10;13:153-9
pubmed: 25750703
Clin Infect Dis. 2019 Apr 8;68(8):1420-1426
pubmed: 30137245
Transpl Infect Dis. 2019 Dec;21(6):e13187
pubmed: 31585500
Am J Transplant. 2021 Apr;21(4):1622-1628
pubmed: 33320429
Biol Blood Marrow Transplant. 2014 Dec;20(12):1958-67
pubmed: 25139217
Mediterr J Hematol Infect Dis. 2019 Jan 01;11(1):e2019001
pubmed: 30671207
Rev Med Virol. 2016 May;26(3):161-82
pubmed: 26990717
J Clin Microbiol. 2018 Mar 26;56(4):
pubmed: 29305542
Clin Microbiol Rev. 2010 Oct;23(4):689-712
pubmed: 20930070
Infect Drug Resist. 2019 Jun 04;12:1481-1491
pubmed: 31239725
J Antimicrob Chemother. 2009 Mar;63(3):600-8
pubmed: 19147520
Eur J Case Rep Intern Med. 2020 Apr 20;7(7):001622
pubmed: 32665929
Am J Transplant. 2020 Jun;20(6):1703-1711
pubmed: 31883426
Transpl Immunol. 2016 Feb;34:60-4
pubmed: 26687013
Med Microbiol Immunol. 2019 Dec;208(6):825-834
pubmed: 31289930

Auteurs

Angela Chiereghin (A)

Section of Microbiology, Department of Specialized, Experimental, and Diagnostic Medicine, University of Bologna, Bologna, Italy.
Department of Public Health, Local Health Authority of Bologna, Bologna, Italy.

Tamara Belotti (T)

Pediatric Oncology and Haematology Unit "Lalla Seragnoli", Department of Pediatrics, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Eva Caterina Borgatti (EC)

Microbiology Unit, Department of Specialized, Experimental, and Diagnostic Medicine, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Nicola Fraccascia (N)

Nuclear Medicine Unit, Department of Specialized, Experimental, and Diagnostic Medicine, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Giulia Piccirilli (G)

Microbiology Unit, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Maura Fois (M)

Pediatric Oncology and Haematology Unit "Lalla Seragnoli", Department of Pediatrics, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Michele Borghi (M)

Microbiology Unit, Department of Specialized, Experimental, and Diagnostic Medicine, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Gabriele Turello (G)

Microbiology Unit, Department of Specialized, Experimental, and Diagnostic Medicine, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Liliana Gabrielli (L)

Microbiology Unit, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Riccardo Masetti (R)

Pediatric Oncology and Haematology Unit "Lalla Seragnoli", Department of Pediatrics, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Arcangelo Prete (A)

Pediatric Oncology and Haematology Unit "Lalla Seragnoli", Department of Pediatrics, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Stefano Fanti (S)

Nuclear Medicine Unit, Department of Specialized, Experimental, and Diagnostic Medicine, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Tiziana Lazzarotto (T)

Microbiology Unit, Department of Specialized, Experimental, and Diagnostic Medicine, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy.

Classifications MeSH