Viral infection after hematopoietic stem cell transplantation

Viral infections are important complications after allogeneic hematopoietic stem cell transplantation. New infections develop such as SARS-CoV-2 with the potential for severe consequences. In this review, newly published information regarding management of viral infections is discussed.

Letermovir and maribavir are antiviral agents that have positively impacted the management of cytomegalovirus infections. These should today be included in treatment algorithms. The first antiviral cellular therapy for anti-CD20 refractory EBV-associated lymphoproliferative disease is now licensed and available. Vaccination as well as introduction of antiviral agents, mAbs and possibly the development of different viral strains have reduced mortality in COVID-19 in this patient population. Well designed studies have shown the improved immunogenicity of high-dose influenza vaccines. There is still an unmet medical need for patients infected with human metapneumovirus and parainfluenza viruses.

Although improvements in patient management for several important posttransplantation viral infections have been reported, an unmet medical need still exists for other viruses occurring in this high-risk population.