Pharmacologic and immunologic management of cytomegalovirus infection after solid organ and hematopoietic stem cell transplantation

Atibordee Meesing, Raymund R Razonable

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Introduction: Cytomegalovirus (CMV) is a common opportunistic infection that causes significant morbidity and preventable mortality after solid-organ and allogeneic hematopoietic stem cell transplantation. Areas covered: Current strategies of pharmacological treatment of CMV in solid-organ and hematologic stem cell transplantation are reviewed. The role of the newly approved drug, letermovir, and other novel investigational compounds is discussed. The complementary role of viral and immunologic monitoring in guiding the optimal role of pharmacologic agents on the management of CMV after transplantation is highlighted. Advances in immunotherapeutics are highlighted. Expert commentary: With advances in therapeutic and diagnostic modalities, the management of CMV infection and disease after transplantation continues to evolve. The authors provide a succinct yet comprehensive review of the current prevention and treatment for CMV infection and disease in transplant recipients. The role of the newly approved drug, letermovir, for CMV prevention is highlighted in the context of current prevention strategies after allogeneic hematopoietic stem cell transplantation. The emerging role of cell-mediated immunologic monitoring, which complements the established function of viral load testing, is emphasized. Finally, the integration of novel antiviral therapies, standardized molecular tests, immunologic assays, and immunotherapeutics are discussed.

Original languageEnglish (US)
Pages (from-to)773-788
Number of pages16
JournalExpert Review of Clinical Pharmacology
Volume11
Issue number8
DOIs
StatePublished - Aug 3 2018

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Hematopoietic Stem Cell Transplantation
Cytomegalovirus Infections
Cytomegalovirus
Immunologic Monitoring
Transplantation
Immunologic Tests
Opportunistic Infections
Stem Cell Transplantation
Therapeutics
Viral Load
Pharmaceutical Preparations
Antiviral Agents
Pharmacology
Morbidity
Mortality
AIC246

Keywords

  • cidofovir
  • Cytomegalovirus
  • foscarnet
  • ganciclovir
  • hematopoietic stem cell transplantation
  • immunity
  • letermovir
  • monitoring
  • preemptive therapy
  • prophylaxis
  • resistance
  • solid organ transplantation
  • valganciclovir
  • viral load

ASJC Scopus subject areas

  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Pharmacology (medical)

Cite this

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title = "Pharmacologic and immunologic management of cytomegalovirus infection after solid organ and hematopoietic stem cell transplantation",
abstract = "Introduction: Cytomegalovirus (CMV) is a common opportunistic infection that causes significant morbidity and preventable mortality after solid-organ and allogeneic hematopoietic stem cell transplantation. Areas covered: Current strategies of pharmacological treatment of CMV in solid-organ and hematologic stem cell transplantation are reviewed. The role of the newly approved drug, letermovir, and other novel investigational compounds is discussed. The complementary role of viral and immunologic monitoring in guiding the optimal role of pharmacologic agents on the management of CMV after transplantation is highlighted. Advances in immunotherapeutics are highlighted. Expert commentary: With advances in therapeutic and diagnostic modalities, the management of CMV infection and disease after transplantation continues to evolve. The authors provide a succinct yet comprehensive review of the current prevention and treatment for CMV infection and disease in transplant recipients. The role of the newly approved drug, letermovir, for CMV prevention is highlighted in the context of current prevention strategies after allogeneic hematopoietic stem cell transplantation. The emerging role of cell-mediated immunologic monitoring, which complements the established function of viral load testing, is emphasized. Finally, the integration of novel antiviral therapies, standardized molecular tests, immunologic assays, and immunotherapeutics are discussed.",
keywords = "cidofovir, Cytomegalovirus, foscarnet, ganciclovir, hematopoietic stem cell transplantation, immunity, letermovir, monitoring, preemptive therapy, prophylaxis, resistance, solid organ transplantation, valganciclovir, viral load",
author = "Atibordee Meesing and Razonable, {Raymund R}",
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T1 - Pharmacologic and immunologic management of cytomegalovirus infection after solid organ and hematopoietic stem cell transplantation

AU - Meesing, Atibordee

AU - Razonable, Raymund R

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N2 - Introduction: Cytomegalovirus (CMV) is a common opportunistic infection that causes significant morbidity and preventable mortality after solid-organ and allogeneic hematopoietic stem cell transplantation. Areas covered: Current strategies of pharmacological treatment of CMV in solid-organ and hematologic stem cell transplantation are reviewed. The role of the newly approved drug, letermovir, and other novel investigational compounds is discussed. The complementary role of viral and immunologic monitoring in guiding the optimal role of pharmacologic agents on the management of CMV after transplantation is highlighted. Advances in immunotherapeutics are highlighted. Expert commentary: With advances in therapeutic and diagnostic modalities, the management of CMV infection and disease after transplantation continues to evolve. The authors provide a succinct yet comprehensive review of the current prevention and treatment for CMV infection and disease in transplant recipients. The role of the newly approved drug, letermovir, for CMV prevention is highlighted in the context of current prevention strategies after allogeneic hematopoietic stem cell transplantation. The emerging role of cell-mediated immunologic monitoring, which complements the established function of viral load testing, is emphasized. Finally, the integration of novel antiviral therapies, standardized molecular tests, immunologic assays, and immunotherapeutics are discussed.

AB - Introduction: Cytomegalovirus (CMV) is a common opportunistic infection that causes significant morbidity and preventable mortality after solid-organ and allogeneic hematopoietic stem cell transplantation. Areas covered: Current strategies of pharmacological treatment of CMV in solid-organ and hematologic stem cell transplantation are reviewed. The role of the newly approved drug, letermovir, and other novel investigational compounds is discussed. The complementary role of viral and immunologic monitoring in guiding the optimal role of pharmacologic agents on the management of CMV after transplantation is highlighted. Advances in immunotherapeutics are highlighted. Expert commentary: With advances in therapeutic and diagnostic modalities, the management of CMV infection and disease after transplantation continues to evolve. The authors provide a succinct yet comprehensive review of the current prevention and treatment for CMV infection and disease in transplant recipients. The role of the newly approved drug, letermovir, for CMV prevention is highlighted in the context of current prevention strategies after allogeneic hematopoietic stem cell transplantation. The emerging role of cell-mediated immunologic monitoring, which complements the established function of viral load testing, is emphasized. Finally, the integration of novel antiviral therapies, standardized molecular tests, immunologic assays, and immunotherapeutics are discussed.

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KW - foscarnet

KW - ganciclovir

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KW - letermovir

KW - monitoring

KW - preemptive therapy

KW - prophylaxis

KW - resistance

KW - solid organ transplantation

KW - valganciclovir

KW - viral load

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