ArticleBone marrow transplantation2004
Use of leflunomide in an allogeneic bone marrow transplant recipient with refractory cytomegalovirus infection.
Article in Bone marrow transplantation, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 103 citations in OpenAlex.
- Guideline
- Management of CMV, HHV-6, HHV-7 and Kaposi-sarcoma herpesvirus (HHV-8) infections in patients with hematological malignancies and after SCT.Bone marrow transplantation · 2008Guideline
- Recent advances in human cytomegalovirus: a comprehensive review of pathogenic mechanisms, virus-host interactions, and antiviral strategies.Frontiers in immunology · 2025Review
- Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review.Frontiers in pediatrics · 2022Review
- In-depth summary over cytomegalovirus infection in allogeneic hematopoietic stem cell transplantation recipients.Virusdisease · 2021Review
- Article
- Leflunomide in the Treatment of a Pseudotumoral Genital Herpes Simplex Virus Infection in an HIV Patient.Case reports in infectious diseases · 2017Article
- How I treat resistant cytomegalovirus infection in hematopoietic cell transplantation recipients.Blood · 2016Article
- CNS infections in patients with hematological disorders (including allogeneic stem-cell transplantation)-Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO).Annals of oncology : official journal of the European Society for Medical Oncology · 2016Article
- Cross Talk between Nucleotide Synthesis Pathways with Cellular Immunity in Constraining Hepatitis E Virus Replication.Antimicrobial agents and chemotherapy · 2016Article
- Leflunomide inhibits the apoptosis of human embryonic lung fibroblasts infected by human cytomegalovirus.European journal of medical research · 2013Article
- Leflunomide reduces proliferation and induces apoptosis in neuroblastoma cells in vitro and in vivo.PloS one · 2013Article
- Identification of broad-spectrum antiviral compounds and assessment of the druggability of their target for efficacy against respiratory syncytial virus (RSV).Proceedings of the National Academy of Sciences of the United States of America · 2011Article
- Cytomegalovirus in hematopoietic stem cell transplant recipients.Hematology/oncology clinics of North America · 2011Article
- Antiviral drug resistance of human cytomegalovirus.Clinical microbiology reviews · 2010Review
- Antiviral drug resistance: mechanisms and clinical implications.Infectious disease clinics of North America · 2010Review
- Review
- Antiviral therapy for respiratory tract infections.Respirology (Carlton, Vic.) · 2008Review
- Polyomavirus BK infection in blood and marrow transplant recipients.Bone marrow transplantation · 2008Review
- Salvage with a mini-allograft after primary engraftment failure following autologous transplant for multiple myeloma.Bone marrow transplantation · 2007Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ganciclovir-resistant cytomegalovirus (CMV) infection is an emerging problem in transplant recipients. Foscarnet resistance and cidofovir resistance have also been described, but no previous reports have suggested treatment regimens for patients with CMV refractory to all three of these drugs. Leflunomide, an immunosuppressive drug used in rheumatoid arthritis and in rejection in solid-organ transplantation, has been reported to have novel anti-CMV activity. However, its clinical utility in CMV treatment has not been described previously. We report an allogeneic bone marrow transplant recipient who developed CMV infection refractory to sequential therapy with ganciclovir, foscarnet, and cidofovir. The patient was ultimately treated with a combination of leflunomide and foscarnet. Both phenotypic and genotypic virologic analysis was performed on sequential CMV isolates. The patient's high CMV-DNA viral load became undetectable on leflunomide and foscarnet, but the patient, who had severe graft-versus-host disease (GVHD) of the liver, expired with progressive liver failure and other complications. We concluded that leflunomide is a new immunosuppressive agent with anti-CMV activity, which may be useful in the treatment of multiresistant CMV. However, the toxicity profile of leflunomide in patients with underlying GVHD remains to be defined.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.