列特莫维尔用于异性造血细胞移植后的先发性细胞巨乳病毒治疗
Raena Kaur1, Duncan Purtill1, Julian Cooney1
1Department of Haematology, Fiona Stanley Hospital and PathWest Laboratory Medicine WA, Murdoch, Australia.
概括
莱特莫维尔 (LTV) 在移植患者中有效控制了细胞巨乳病毒 (CMV) 病毒性病,显示了细胞衰竭的改善. 这表明LTV可能是一个可行的替代品valganciclovir用于CMV移植后预防性治疗.
科学领域:
- 血液学 血液学 血液学
- 病毒学 病毒学
- 移植医学 移植医学
背景情况:
- 细胞巨乳病毒 (CMV) 感染是异性造血细胞移植 (alloHCT) 后并发症的重要原因.
- 目前使用瓦尔甘西克洛维尔 (VGC) 的预防性治疗 (PET) 与不良的血液学影响有关,包括细胞衰竭.
研究的目的:
- 为了评估莱特莫维尔 (LTV) 在患有细胞衰竭的alloHCT患者中进行CMV预防性治疗的疗效和安全性.
- 为了比较LTV与VGC在控制CMV病毒病和管理血液毒性的表现.
主要方法:
- 分析了一组10名alloHCT患者的队列,这些患者在2018年至2021年期间因细胞衰竭而接受CMV PET的LTV.
- 六名患者在过渡到LTV之前先前接受了VGC.
- 评估的关键参数包括治疗时间,持续时间,CMV病毒载量和细胞衰竭的变化.
主要成果:
- 与VGC相比,LTV的启动时间较晚 (中位数为90天),初始CMV病毒载量较低 (2.9 log10 IU/mL),而VGC的启动时间较晚 (中位数为42天,3.7 log10 IU/mL).
- 这两种抗病毒药物表现出每周可比的病毒载量减少率 (LTV:0.17 log10 IU/mL/week;VGC:0.18 log10 IU/mL/week).
- 患者在LTV治疗期间表现出改善的细胞衰竭,在停止治疗后没有显著的CMV病毒病.
结论:
- 莱特莫维尔在控制CMV病毒血症方面表现出有效性,特别是在晚些时候启动时,以及与VGC相比,在alloHCT后的病毒载量较低时.
- LTV对细胞衰竭产生了有利影响,这表明其作为替代PET策略的潜力.
- 需要进一步调查LTV作为HCT配合后的前期PET剂.
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