[Maribavir treatment for refractory and drug-intolerant cytomegalovirus viremia and disease after allogeneic hematopoietic stem cell transplantation: a clinical analysis of 25 cases].

W Ma, Z J Wei, Y Lu, J P Zhang, R J Sun, M Xiong, J R Zhou, L Dong, S Xue, X Y Cao
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Abstract

Objective: To investigate the safety and efficacy of maribavir for the treatment of CMV viremia and CMV disease refractory or intolerant to conventional antiviral drugs after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: This study retrospectively analyzed the clinical characteristics and outcomes of CMV viremia and CMV disease refractory or intolerant to conventional antiviral drugs after allo-HSCT treated with maribavir at Hebei Yanda Lu Daopei Hospital from April 2024 to September 2024. Result: A total of 25 patients received maribavir, including 21 haploidentical transplants, two sibling HLA-matched transplants, and 2 HLA-matched unrelated transplants. Among them, 21, 2, and 2 patients received the first, second, and third transplants, respectively. The median time to the onset of CMV viremia and CMV disease was 120.5 (6-298) days post-transplantation. The median peak plasma CMV copy number was 6 400 copies/ml (range: 1 100-650 000 copies/ml). Six patients were diagnosed with CMV disease. Maribavir was administered after a median of 9.5 (1-41) days after CMV infection. The median duration of maribavir administration was 11.5 (6-43) days. Post-treatment, maribavir was effective in 25 (100%) patients. Two patients experienced grade 1 taste abnormalities, and one patient experienced grade 2 myelosuppression. Conclusion: The application of maribavir after allo-HSCT for treating refractory, drug-intolerant CMV viremia and CMV disease is safe and effective.

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【马里巴韦治疗同种异体造血干细胞移植后难治性、耐药性巨细胞病毒血症及疾病25例临床分析】。
目的:探讨马里巴韦治疗同种异体造血干细胞移植(allogeneic hematopoietic stem cell transplantation, alloo - hsct)术后CMV病毒血症及对常规抗病毒药物难治或不耐受的CMV疾病的安全性和有效性。方法:回顾性分析2024年4月至2024年9月河北延达路道培医院接受马里巴韦治疗的同种异体造血干细胞移植术后CMV病毒血症及常规抗病毒药物难治或不耐受的CMV疾病的临床特点及结局。结果:共25例患者接受了马里巴韦治疗,其中单倍体移植21例,兄弟姐妹hla匹配移植2例,非亲属hla匹配移植2例。其中,接受第一次、第二次、第三次移植的患者分别为21例、2例、2例。移植后发生巨细胞病毒血症和巨细胞病毒疾病的中位时间为120.5(6-298)天。血浆CMV拷贝数中位峰为6 400拷贝/ml(范围:1 100-65万拷贝/ml)。6例患者被诊断为巨细胞病毒病。马里巴韦在巨细胞病毒感染后中位时间为9.5(1-41)天。马里巴韦给药的中位持续时间为11.5(6-43)天。治疗后,马里巴韦对25例(100%)患者有效。两名患者经历了1级味觉异常,一名患者经历了2级骨髓抑制。结论:同种异体造血干细胞移植后应用马里巴韦治疗难治性、药物不耐受的巨细胞病毒血症和巨细胞病毒病安全有效。
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来源期刊
CiteScore
0.80
自引率
0.00%
发文量
100
期刊最新文献
[Comparison of the efficacy and safety between high-dose intravenous iron and oral iron in treating iron deficiency anemia: a multicenter, prospective, open-label, randomized controlled study]. [Clinical features and prognosis of Pseudomonas aeruginosa infection in patients with hematologic malignancies]. [Early cellular immune exhaustion in patients with Epstein-Barr virus activation following haploidentical hematopoietic stem cell transplantation]. [Improving the application of metagenomic next-generation sequencing for pathogen diagnosis in infections related to hematological diseases]. [Maribavir treatment for refractory and drug-intolerant cytomegalovirus viremia and disease after allogeneic hematopoietic stem cell transplantation: a clinical analysis of 25 cases].
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