Evidence map›Paper›PMID 33220125›Full record

ArticleTransplant infectious disease : an official journal of the Transplantation Society2021

Outcomes of transplant recipients treated with cidofovir for resistant or refractory cytomegalovirus infection.

Seema A Mehta Steinke, Mona Alfares, Alexandra Valsamakis, Shmuel Shoham, Ravit Arav-Boger, Laura Lees, Darin Ostrander, Michael S Forman, Audra Shedeck, Richard F Ambinder and 2 more

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Transplant infectious disease : an official journal of the Transplantation Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07787767 (Evaluation of Cytomegalovirus Refractoriness and Resistance in Solid Organ Transplantation in Argentina), which is not on this map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT07787767 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Evaluation of Cytomegalovirus Refractoriness and Resistance in Solid Organ Transplantation in Argentina: A Multicenter Study

TypeobservationalSponsorHospital Italiano de Buenos AiresRan2026 to 2027Enrolled200ConditionsCytomegalovirus Infections, Solid Organ Transplantation Recipient, Solid Organ Transplantation
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Maribavir for Refractory Cytomegalovirus Infections With or Without Resistance Post-Transplant: Results From a Phase 3 Randomized Clinical Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Trial
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  6. Review
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  14. New Perspectives on Antimicrobial Agents: Maribavir.Antimicrobial agents and chemotherapy · 2022
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

Seema A Mehta SteinkeDivision of Infectious Diseases, Department of Medicine, Johns Hopkins, Baltimore, MD, USA.ORCID https://orcid.org/0000-0003-2375-7922
Mona AlfaresDivision of Infectious Diseases, Department of Medicine, Johns Hopkins, Baltimore, MD, USA.
Alexandra ValsamakisDivision of Medical Microbiology, Department of Pathology, Johns Hopkins, Baltimore, MD, USA.
Shmuel ShohamDivision of Infectious Diseases, Department of Medicine, Johns Hopkins, Baltimore, MD, USA.
Ravit Arav-BogerDepartment of Pediatrics, Johns Hopkins, Baltimore, MD, USA.
Laura LeesDepartment of Pharmacy, Johns Hopkins, Baltimore, MD, USA.
Darin OstranderDivision of Infectious Diseases, Department of Medicine, Johns Hopkins, Baltimore, MD, USA.
Michael S FormanDivision of Medical Microbiology, Department of Pathology, Johns Hopkins, Baltimore, MD, USA.
Audra ShedeckDepartment of Hematology and Oncology, Johns Hopkins, Baltimore, MD, USA.
Richard F AmbinderDepartment of Hematology and Oncology, Johns Hopkins, Baltimore, MD, USA.
Richard John JonesDepartment of Hematology and Oncology, Johns Hopkins, Baltimore, MD, USA.
Robin K AveryDivision of Infectious Diseases, Department of Medicine, Johns Hopkins, Baltimore, MD, USA.ORCID https://orcid.org/0000-0001-7692-3619
Johns Hopkins University · USChildren's Hospital of Wisconsin · USColorado State University Pueblo · USRoche (United States) · US

Funding

Translational Research Central ServicesP30CA006973 · NCI · JOHNS HOPKINS UNIVERSITY · PI Rosalie Wollett · 1985 to 2026
$208.6M
Targeting MRDP01CA225618 · NCI · JOHNS HOPKINS UNIVERSITY · PI Patrick J Hanley · 2019 to 2026
$15.1M
NCI NIH HHS P01 CA225618NCI NIH HHS P01-CA225618NCI NIH HHS P30 CA006973NCI NIH HHS P30 CA06973
6 · The paper itself

Abstract

backgroundTreatment of ganciclovir-resistant (GCV-R)/refractory cytomegalovirus (CMV) infections in blood/marrow transplant (BMT) and solid organ transplant (SOT) recipients remains suboptimal. Cidofovir (CDV), a nucleotide analogue with anti-CMV activity, is nephrotoxic and oculotoxic.

methodsWe retrospectively evaluated the outcomes of SOT and BMT patients with GCV-R/refractory CMV treated with CDV between 1/1/2008 and 12/31/2017. DATA COLLECTED: baseline demographics, CMV serostatus, clinical and virologic presentations and outcomes, UL97 and UL54 genotype mutations, drug toxicities, and cause of death. Descriptive statistics were used.

results16 patients received CDV for treatment of CMV: six BMT and 10 SOT. Seven (47%) of the patients had high-risk donor/recipient serostatus: six (60%) SOT were D+/R-; one (16.7%) BMT was D-/R+. Median time to CMV DNAemia was 131 days post-transplant (IQR, 37.5-230.3). Proven tissue invasive disease was present in three patients (18.8%). Twelve (75%) had genotype testing; 10 (83.3%) of those had antiviral resistance mutations. While on CDV, six (37.5%) developed nephrotoxicity, and four (25%) developed uveitis (two had both uveitis and nephrotoxicity). Eight (50%) had failure to clear CMV DNAemia despite CDV treatment. Eight (50%) of the patients died; median time to death, after initiation of CDV, was 33.5 days [IQR22-988].

conclusionsIn the absence of good therapeutic alternatives, CDV is used in GCV-R/refractory CMV infection. However, it is associated with a substantial risk of toxicity and failure to clear CMV DNAemia, highlighting the need for development of newer and less toxic therapies. The high mortality in this group of patients underscores the severity of illness in this population.

Indexed as

Cytomegalovirus InfectionsTransplant RecipientsAntiviral AgentsCidofovirCytomegalovirusDrug Resistance, ViralGanciclovirHumansRetrospective StudiesAntiviral AgentsCidofovirGanciclovircidofovirCMVcytomegalovirusganciclovir-resistant CMVresistant/refractory cytomegalovirus

Identifiers

PMID33220125
PMCPMC9353742
OpenAlexW3106789806

What OpenQuestion holds

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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.