Difficult balance between multidrug-resistant cytomegalovirus infection and graft-versus-host disease in an allogeneic hematopoietic stem cell transplant recipient review of antiviral therapy and use of cytomegalovirus-specific T-cells Journal Article

  

Authors:	Rhee, Y.; Santos, C. A. Q.; Lurain, N.; Marinovic, D. A.; Prockop, S. E.; Varma, A.; Papanicolaou, G.; Ustun, C.; Nathan, S.
Article Title:	Difficult balance between multidrug-resistant cytomegalovirus infection and graft-versus-host disease in an allogeneic hematopoietic stem cell transplant recipient review of antiviral therapy and use of cytomegalovirus-specific T-cells
Abstract:	We present a case of multidrug-resistant cytomegalovirus (CMV) infection in an allogeneic hematopoietic stem cell transplant recipient with graft-versus-host disease. We demonstrate evolving viral mutations with documented resistance to first-line CMV DNA polymerase inhibitors and letermovir. Leflunomide and compassionate use investigational third-party CMV-specific cytotoxic T-cell lymphocyte infusions led to reductions in CMV viremia; however, the patient succumbed to respiratory failure. This article highlights the difficult balance between immunosuppression for graft-versus-host disease therapy and refractory CMV treatment, with a review of CMV antiviral therapy. © Wolters Kluwer Health, Inc. All rights reserved.
Keywords:	hematopoietic stem cell transplantation; graft-versus-host disease; multidrug-resistant cytomegalovirus; letermovir resistance; cytomegalovirus-specific t-cells
Journal Title:	Infectious Diseases in Clinical Practice
Volume:	28
Issue:	5
ISSN:	1056-9103
Publisher:	Lippincott Williams & Wilkins
Date Published:	2020-09-01
Start Page:	257
End Page:	260
Language:	English
DOI:	10.1097/ipc.0000000000000858
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85105554867&doi=10.1097%2fIPC.0000000000000858&partnerID=40&md5=58fbfb0a40e7512fe358d0762b1f4491
Notes:	Review -- Export Date: 1 June 2021 -- Source: Scopus

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