Cytotect®CP as salvage therapy in patients with CMV infection following allogeneic hematopoietic cell transplantation: a multicenter retrospective study

Cytomegalovirus is one of the main contributing factors to high mortality rates in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). The main factors of treatment failure are both drug resistance and intolerance. In some cases, Cytotect®CP CMV-hyperimmune globulin is used...

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Bibliographic Details
Published in:Bone marrow transplantation (Basingstoke) 2018-10, Vol.53 (10), p.1328-1335
Main Authors: Alsuliman, Tamim, Kitel, Caroline, Dulery, Rémy, Guillaume, Thierry, Larosa, Fabrice, Cornillon, Jérôme, Labussière-Wallet, Helene, Médiavilla, Clémence, Belaiche, Stéphanie, Delage, Jeremy, Alain, Sophie, Yakoub-Agha, Ibrahim
Format: Article
Language:English
Subjects:
Activation
Adult
Aged
Allografts
Bone marrow
Cytomegalovirus
Cytomegalovirus Infections - drug therapy
Cytomegalovirus Infections - mortality
Drug resistance
Female
Globulins
Graft vs Host Disease - drug therapy
Graft vs Host Disease - mortality
Graft-versus-host reaction
Hematopoietic Stem Cell Transplantation
Humans
Immunoglobulins, Intravenous - administration & dosage
Immunoglobulins, Intravenous - adverse effects
Infections
Intolerance
Life Sciences
Male
Middle Aged
Patients
Retrospective Studies
Safety
Salvage
Salvage Therapy
Statistical analysis
Stem cell transplantation
Therapy
Transplantation
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Summary:Cytomegalovirus is one of the main contributing factors to high mortality rates in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). The main factors of treatment failure are both drug resistance and intolerance. In some cases, Cytotect®CP CMV-hyperimmune globulin is used as salvage therapy. This study aims to investigate the safety and efficacy of Cytotect®CP as a salvage therapy in patients with CMV infection after allo-HCT. Twenty-three consecutive patients received Cytotect®CP for CMV infection after prior CMV therapy. At the time of Cytotect®CP introduction, 17 patients (74%) had developed acute GVHD and 15 patients (64%) were receiving steroid treatment; Cytotect®CP was used as monotherapy (n = 7) and in combination (n = 16). Overall, response was observed in 18 patients (78%) with a median time of 15 days (range: 3-51). Of the 18 responders, 4 experienced CMV reactivation, while 5 responders died within 100 days of beginning treatment. Of these 5 deaths, 4 were due to causes unrelated to CMV. Estimated 100-day OS from the introduction of Cytotect®CP was 69.6%. No statistically significant difference was observed in 100-day OS between responders and non-responders (73.7% vs 50.0%, p = 0.258). Cytotect®CP as salvage therapy is effective and well-tolerated. Given its safety profile, early treatment use should be considered.
ISSN:0268-3369
1476-5365
DOI:10.1038/s41409-018-0166-9