Evidence map›Paper›PMID 41555441›Full record

ArticleEuropean journal of medical research2026

Refining letermovir prophylaxis strategies and CD4 + T cell-guided discontinuation in aplastic anemia patients post-allogeneic HSCT: a retrospective analysis.

Yuling Zhang, Xiaoqing He, Ming Zhou, Yuping Zhang, Wenjian Mo, Ruiqing Zhou, Yumiao Li, Qi Xiang, Fangfang Yang, Shilin Xu and 7 more

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Article in European journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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.

2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

17 authors.

Yuling Zhang *Department of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Xiaoqing He *Department of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Ming ZhouDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Yuping ZhangDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Wenjian MoDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Ruiqing ZhouDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Yumiao LiDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Qi XiangDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Fangfang YangDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Shilin XuDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Caixia WangDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Wei ZhouDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Tingfen DengDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Shiyi PanDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
LiangLiang WuDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China.
Shunqing WangDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China. shqwang_cn@163.com.
Xiaowei ChenDepartment of Hematology, Guangzhou First People's Hospital, Institute of Blood Transfusion and Hematology, Guangzhou Medical University, Guangzhou, 510180, China. hnchxw@126.com.

Funding

Guangzhou General Science and Technology Project of Health and Family Planning 20241A011012Guangzhou Municipal Science and Technology Project 2024A03J1021Science and Technology Projects in Guangzhou 202201010062the Innovative Clinical Technique of Guangzhou 2019GX04the Innovative Clinical Technique of Guangzhou No.2023C-GX01the National Key R&D Program of China 2023YFA1800100
6 · The paper itself

Abstract

introductionCytomegalovirus (CMV) infection is a significant complication in aplastic anemia (AA) patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). While letermovir has shown efficacy in CMV prophylaxis, the optimal timing for discontinuing letermovir remains unclear. This study evaluates the effectiveness of letermovir prophylaxis and explores the role of CD4 + T cells in guiding the appropriate timing for stopping prophylaxis.

methodsThis retrospective cohort study included 129 AA patients who underwent allo-HSCT at Guangzhou First People's Hospital between January 2022 and January 2024. Patients were divided into three groups: Group 1 (no letermovir prophylaxis), Group 2 (letermovir prophylaxis until day 100 post-transplant), and Group 3 (letermovir prophylaxis with discontinuation based on CD4 + T cells after day 100). The primary outcomes assessed were the incidence of CMV infections, overall survival (OS), and the severity of CMV-related infections.

resultsThe incidence of CMV infection was significantly lower in Group 2 (26.3%) and Group 3 (7.1%) compared to Group 1 (77.6%). Group 3, where letermovir discontinuation was guided by CD4 + T cells, showed no CMV infections between days 100 and 200 post-transplant, suggesting that extending prophylaxis based on immune recovery may offer additional protection. The overall survival rate was 93.0%, with no statistically significant difference observed between groups (P = 0.099).

conclusionLetermovir prophylaxis significantly reduces the incidence of CMV infection in AA patients post-allo-HSCT. Discontinuing letermovir based on CD4 + T cells appears to be an effective strategy for minimizing both early and late CMV infections, indicating that immune recovery markers can guide safer and more personalized prophylaxis durations. Further studies are necessary to confirm these findings and refine the criteria for stopping letermovir prophylaxis.

Indexed as

Allogeneic hematopoietic stem cell transplantationAplastic anemiaCytomegalovirus infectionsLetermovir

Identifiers

PMID41555441
PMCPMC12896338

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