Review Articles
Vol. 16 No. 1 (2024): Review Articles, Original Article, Scientific Letter, Case Reports Letter to the Editor
UPDATE ON CYTOMEGALOVIRUS INFECTION MANAGEMENT IN ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANT RECIPIENTS
A Consensus Document of the Spanish Group for Hematopoietic Transplantation and Cell Therapy (GETH-TC)
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: June 10, 2024
Accepted: July 29, 2024
Accepted: July 29, 2024
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Background: Cytomegalovirus (CMV) infection is a common complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT) and in patients receiving novel hematological therapies. Its impact on morbidity and mortality necessitates effective management strategies. Despite recent advances in diagnostics and treatment, unresolved questions persist regarding monitoring and treatment, prompting the need for updated recommendations.
Methods: A consensus was reached among a panel of experts selected for their expertise in CMV research and clinical practice. Key clinical areas and questions were identified based on previous surveys and literature reviews. Recommendations were formulated through consensus and graded using established guidelines.
Results: Recommendations were provided for virological monitoring, including the timing and frequency of CMV DNAemia surveillance, especially during letermovir (LMV) prophylaxis. We evaluated the role of CMV DNA load quantification in diagnosing CMV disease, particularly pneumonia and gastrointestinal involvement, along with the utility of specific CMV immune monitoring in identifying at-risk patients. Strategies for tailoring LMV prophylaxis, managing breakthrough DNAemia, and implementing secondary prophylaxis in refractory cases were outlined. Additionally, criteria for initiating early antiviral treatment based on viral load dynamics were discussed.
Conclusion: The consensus provides updated recommendations for managing CMV infection in hematological patients, focusing on unresolved issues in monitoring, prophylaxis, treatment, and resistance. These recommendations aim to guide clinical practice and improve outcomes in this high-risk population. Further research is warranted to validate these recommendations and address ongoing challenges in CMV management with emerging antiviral combinations, particularly in pediatric populations.
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Ethics Approval
Consensus on Management of CMV Infection in Allo-HSCT recipientsSupporting Agencies
Infectious Complications Committee (GRUCINI) of the Spanish Group of Hematopoietic Transplantation and Cellular Therapy (GETH-TC)How to Cite
“UPDATE ON CYTOMEGALOVIRUS INFECTION MANAGEMENT IN ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANT RECIPIENTS: A Consensus Document of the Spanish Group for Hematopoietic Transplantation and Cell Therapy (GETH-TC)” (2024) Mediterranean Journal of Hematology and Infectious Diseases, 16(1), p. e2024065. doi:10.4084/MJHID.2024.065.
Copyright (c) 2024 José Luis Piñana, Estela Giménez, Lourdes Vázquez, María Ángeles Marcos, Manuel Guerreiro, Rafael Duarte, Ariadna Pérez, Carlos de Miguel, Ildefonso Espigado, Marta González-Vicent, María Suarez-Lledó, Irene García-Cadenas, Rodrigo Martino, Angel Cedillo, Monserrat Rovira, Rafael de la Cámara, David Navarro, Carlos Solano
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