ArticleBone marrow transplantation2023
Cytomegalovirus breakthrough and resistance during letermovir prophylaxis.
Article in Bone marrow transplantation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
What it found
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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.
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Who cites it
29 citing papers in PubMed, 37 citations in OpenAlex.
- Cytomegalovirus Antiviral Resistance Among Kidney Transplant Recipients in a Phase 3 Trial of Letermovir vs Valganciclovir Prophylaxis.The Journal of infectious diseases · 2024Trial
- Final outcomes from a phase 2 trial of posoleucel in allogeneic hematopoietic cell transplant recipients.Blood advances · 2024Trial
- A real-world study on different initiation times and treatment durations of letermovir for cytomegalovirus prophylaxis after allogeneic haematopoietic stem cell transplantation.British journal of haematology · 2026Article
- Human Cytomegalovirus Infection in Haematopoietic Stem Cell Transplant Recipients and CAR-T Cell Recipients-PART 2: Antiviral Therapy and Virus-Specific T Cell Therapy for HCMV in Allo-HSCT.Reviews in medical virology · 2026Review
- Letermovir prophylaxis and early CMV DNAemia after allogeneic hematopoietic stem cell transplantation: a real‑world study from China.Scientific reports · 2026Article
- Cytomegalovirus infection post-hematopoietic stem cell transplantation: a real-world perspective on risk factors and clinical practice.Clinical transplantation and research · 2026Article
- Pretransplant CMV-IgG Titers and DNAemia Are Associated With CMV Infections Post Allogeneic Hematopoietic Cell Transplant With or Without Letermovir.Open forum infectious diseases · 2026Article
- Safety signals and CMV-related events reported during letermovir therapy: a FAERS database study.Frontiers in pharmacology · 2026Article
- The HCMV terminase as an antiviral target: structural insights, inhibitory mechanisms, and the era of letermovir.Frontiers in microbiology · 2026Review
- A New Next-Generation Sequencing Approach in Human Cytomegalovirus for the Identification of Antiviral Resistance Mutations and Genotypic Classification.Journal of medical virology · 2025Article
- Article
- ELISPOT as a predictor of clinically significant cytomegalovirus infection after hematopoietic cell transplantation in letermovir recipients.Bone marrow transplantation · 2025Article
- Eye on cytomegalovirus: Unveiling the ophthalmic impact of cytomegalovirus.World journal of virology · 2025Article
- Identification of a binding pocket of letermovir in the terminase subunit pUL56 of human cytomegalovirus.Scientific reports · 2025Article
- Discovery of Novel Pyrido[2,3-b]Pyrazine Human Cytomegalovirus Polymerase Inhibitors with Broad Spectrum Antiherpetic Activity and Reduced hERG Inhibition.ChemMedChem · 2025Article
- Revealing the Unseen: Next-Generation Sequencing for Early Detection of Drug-Resistant Cytomegalovirus Variants Upon Letermovir Prophylaxis Failure.The Journal of infectious diseases · 2025Article
- Increased EBV infection and relapse following haploidentical hematopoietic cell transplantation in the era of letermovir for cytomegalovirus prophylaxis: a propensity score matching analysis.Frontiers in cellular and infection microbiology · 2025Article
- Revisiting cytomegalovirus in pediatric allogeneic hematopoietic stem cell transplant recipients: current strategies for prevention and management in the letermovir era.Frontiers in pediatrics · 2025Review
- CMV reactivation during pretransplantation evaluation: a novel risk factor for posttransplantation CMV reactivation.Blood advances · 2024Article
- Review
Corrections and comments
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Authors and funding
13 authors at 5 institutions in 2 countries.
Funding
Abstract
Letermovir is a relatively new antiviral for prophylaxis against cytomegalovirus (CMV) after allogeneic hematopoietic cell transplantation (HCT). CMV-seropositive HCT recipients who received letermovir prophylaxis from 2018 to 2020 at our center were evaluated for letermovir resistance and breakthrough CMV reactivation. Two-hundred twenty-six letermovir recipients were identified and 7/15 (47%) with CMV DNAemia ≥200 IU/mL were successfully genotyped for UL56 resistance. A single C325Y resistance mutation was identified in an umbilical cord blood recipient. Ninety-five (42%), 43 (19%), and 15 (7%) patients had breakthrough CMV at any level, ≥150 IU/mL, and ≥500 IU/mL, respectively. Risk factors for breakthrough CMV reactivation at each viral threshold were examined. Cumulative steroid exposure was the strongest risk factor for CMV at all evaluated viral thresholds. Graft-versus-host disease prophylaxis with post-transplantation cyclophosphamide (aHR 2.34, 95% CI 1.28-4.28, p = 0.001) or calcineurin inhibitors plus mycophenolate (aHR 2.24, 95% CI 1.30-3.86, p = 0.004) were also associated with an increased risk of CMV reactivation at any level. De novo letermovir resistance is rare and can be successfully treated using other antivirals. Letermovir effectively prevents clinically significant CMV, however, subclinical CMV reactivation occurs frequently at our center.
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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.