在固体器官移植中用于细胞巨乳病毒预防的莱特莫维尔转化
Suneri J Amin1, Alex W Rogers1, Allison N Yun1
1Department of Pharmacy, Houston Methodist Hospital, Houston, Texas, USA.
Clinical transplantation
|October 25, 2025
概括
莱特莫维尔 (LTV) 在非脏移植患者中有效改善了白细胞 (WBC) 计数,为导致骨髓抑制的传统药物提供了更安全的替代品. 这项研究强调了LTV.
科学领域:
- 移植医学 移植医学
- 传染病 传染病 传染病
- 血液学 血液学 血液学
背景情况:
- 细胞巨乳病毒 (CMV) 感染是实体器官移植后的重大风险.
- 传统的预防药物,如 (val) 甘西克洛维尔,可能会导致骨髓抑制,限制了它们的使用.
- 莱特莫维尔 (LTV) 已被批准用于移植,但对非和多器官移植群体的数据有限.
研究的目的:
- 评估Letermovir (LTV) 对非脏移植受体的细胞巨乳病毒 (CMV) 预防的疗效和安全性.
- 为了评估LTV对白细胞 (WBC) 数量恢复的影响.
- 确定突破性CMV感染的发病率,并确定转向LTV的原因.
主要方法:
- 对58名非脏移植患者进行了回顾性,单中心的队列研究,这些患者从 (val) ganciclovir转换为LTV.
- 从LTV开始到转换后30天的WBC数量的评估变化.
- 记录了LTV转换和突破性CMV感染率的证据.
主要成果:
- 中位数白细胞计数增加了+2.07 k/μLLLTV开始后 (p < 0.01).
- 泛cytopenia 是最常见的转换到LTV (45%) 的原因.
- 突破性CMV病毒病发生在7%没有耐药性的患者中;观察到甲酸盐使用量增加和G-CSF减少.
结论:
- 莱特莫维尔 (LTV) 在外移植患者的CMV预防中有效且耐受良好.
- 对于患有 (val) ganciclovir 血液毒性的患者来说,LTV 可能是安全的替代方案.
- 这些发现支持在各种移植群体中使用LTV,这些人面临着CMV预防方面的挑战.
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