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Isolation and Transplantation of Hematopoietic Stem Cells HSCs
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Profilaxis secundaria con el letermovir genérico bioequivalente en el trasplante de células madre hematopoyéticas
Abhijit Baheti1, Suyash Bharat2
1Hematology, Deenanath Mangeshkar Hospital, Pune, IND.
Cureus
|February 10, 2026
Resumen
La reactivación del citomegalovirus (CMV) es un riesgo después de los trasplantes de células madre. Este caso muestra el manejo exitoso en pacientes ambulatorios de la reactivación del CMV con valganciclovir oral después de la profilaxis inicial, destacando las estrategias antivirales sostenidas.
Área de la Ciencia:
- Hematología Hematología.
- Enfermedades infecciosas Enfermedades infecciosas.
- Inmunología del trasplante Inmunología del trasplante.
Sus antecedentes:
- La reactivación del citomegalovirus (CMV) es una complicación importante después del trasplante de células madre hematopoyéticas alogénicas (HSCT).
- Los pacientes de alto riesgo sometidos a HSCT, especialmente aquellos con insuficiencia del injerto, se enfrentan a una mayor susceptibilidad a la infección por CMV.
- La profilaxis y el manejo efectivos del CMV son cruciales para mejorar los resultados de los trasplantes.
Objetivo del estudio:
- Para reportar un caso de reactivación del CMV en un paciente con leucemia mieloide aguda recidivante post-haploiditaria HSCT con insuficiencia del injerto.
- Para ilustrar el manejo exitoso en pacientes ambulatorios de la reactivación transitoria del CMV.
- Hacer hincapié en la importancia de la profilaxis sostenida del CMV y las terapias antivirales accesibles.
Principales métodos:
- Un paciente con leucemia mieloide aguda recidivante fue sometido a HSCT haploidéntica.
- La profilaxis de Letermovir se administró para la supresión del CMV.
- La reactivación del CMV se produjo después de la interrupción de la profilaxis y se trató con valganciclovir oral.
- Se monitoreó el curso clínico y la respuesta al tratamiento.
Principales resultados:
- La profilaxis con Letermovir suprimió con éxito el CMV inicialmente.
- La reactivación transitoria del CMV se produjo después de la interrupción de la profilaxis con letermovir en el día +60 post-HSCT.
- El tratamiento ambulatorio con valganciclovir oral manejó eficazmente la reactivación del CMV.
- El paciente logró un injerto exitoso y una recuperación clínica.
Conclusiones:
- La profilaxis sostenida del CMV puede ser necesaria en ciertos entornos de HSCT de alto riesgo.
- Los agentes antivirales orales accesibles como el valganciclovir son efectivos para controlar la reactivación del CMV en el entorno ambulatorio.
- La optimización de las estrategias antivirales es clave para mejorar los resultados para los receptores de HSCT en riesgo de CMV.
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