Evidence map›Paper›PMID 42099649›Full record

ArticleFrontiers in immunology2026

Clinical and immunological analysis of letermovir for preventing cytomegalovirus infection in children after hematopoietic stem cell transplantation.

Qing Liu, Bing Zhou, Na Zhang, Hong Li, Sijian Wang, Shumin Hou, Yilin Wang, Pan Fu, Tianqiao Zhong, Jingbo Shao and 2 more

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Article in Frontiers in immunology, 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.

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Qing LiuDepartment of Hematology and Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Bing ZhouDepartment of Hematology and Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Na ZhangDepartment of Hematology and Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Hong LiDepartment of Hematology and Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Sijian WangClinical Laboratory Department, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Shumin HouDepartment of Hematology and Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Yilin WangDepartment of Hematology and Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Pan FuDepartment of Hematology and Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Tianqiao ZhongDepartment of Hematology and Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Jingbo ShaoDepartment of Hematology and Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Kai ChenDepartment of Hematology and Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Hui JiangDepartment of Hematology and Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: The present study aimed to analyze the efficacy and safety of letermovir for preventing cytomegalovirus (CMV) infection and its impact on immune reconstitution in children after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: The retrospective analysis included 83 patients who underwent allo-HSCT at Shanghai Children's Hospital between January 2022 and June 2025 and survived ≥100 days post-transplantation. Forty patients received letermovir as primary CMV prophylaxis (letermovir group), and 43 patients did not receive prophylaxis (control group). The primary outcomes were the post-transplantation incidence of CMV infection and CMV disease. Secondary outcomes included the effects of letermovir on acute graft-versus-host disease (aGVHD), hematopoietic reconstitution (time to neutrophil and platelet engraftment), liver function, incidences of Epstein-Barr virus (EBV) and BK virus (BKV) infections, and cellular immune reconstitution. Results: The cumulative incidence of CMV infection post-transplantation was significantly lower in the letermovir group than in the control group (100 days: 7.5% vs. 53.5%, p<0.001; 180 days: 12.5% vs. 53.5%, p<0.001). No CMV disease occurred in either group. CMV reactivation occurred in 3 patients (7.5%) after discontinuation of letermovir. In the letermovir group, CMV infection occurred later [mean (range): 90.7 (31-168) days vs. 42.7 (16-90) days, p=0.050], lasted for a shorter duration [11.8 (7-15) days vs. 17.5 (4-39) days, p=0.042], and had a lower mean viral load [3,175 copies/ml vs. 30,407 copies/ml, p=0.393]. No significant differences were observed between the two groups in the time to neutrophil and platelet engraftment, incidence of grade II-IV and III-IV aGVHD, incidence of liver function abnormalities, or rates of EBV/BKV infection. Multivariate analysis showed that letermovir prophylaxis was an independent protective factor against CMV infection within 100 days post-transplantation (hazard ratio: 0.127, p=0.001). At 90 days, 180 days, and 1 year post-transplantation, the T lymphocyte and B lymphocyte counts were significantly lower in the letermovir group than in the control group (p<0.05). By 1 year post-transplantation, there was no difference in NK cell counts between the two groups (p=0.094). Within the letermovir group, only CD8 Conclusion: Letermovir is safe and effective at reducing the risk of CMV infection in children after allo-HSCT, significantly delaying the onset of infection and shortening its duration. Although letermovir may impact early lymphocyte subset reconstitution, immune function can recover to pre-transplantation levels by 1 year post-transplantation.

Indexed as

AcetatesAntiviral AgentsCytomegalovirusCytomegalovirus InfectionsHematopoietic Stem Cell TransplantationQuinazolinesAdolescentChildChild, PreschoolFemaleGraft vs Host DiseaseHumansIncidenceInfantMaleRetrospective StudiesAcetatesAntiviral AgentsletermovirQuinazolineschildrencytomegalovirushematopoietic stem cell transplantationimmune reconstitutionletermovirprevention

Identifiers

PMID42099649
PMCPMC13143763

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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.