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The following is a summary of “Increased Epstein‒Barr virus reactivation following prophylaxis for cytomegalovirus infection after haploidentical haematopoietic stem cell transplantation,” published in the October 2024 issue of Hematology by Kong et al.
Letermovir (LTV) prophylaxis reduces clinically significant cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Since June 2022, increased Epstein–Barr virus (EBV) reactivation was observed after haploidentical HSCT with LTV prophylaxis.
Researchers conducted a retrospective study to evaluate the impact of LTV prophylaxis on EBV reactivation after haploidentical HSCT.
They conducted a retrospective analysis of 230 patients who underwent haploidentical HSCT with rabbit anti-thymocyte globulin (ATG) from October 2022 to June 2023. The LTV group included 133 patients receiving LTV prophylaxis, and the control group included 97 patients without LTV prophylaxis.
The results showed that at 1-year post-HSCT, EBV reactivation occurred in 27% of the LTV group and 13% of the control group (P = 0.012), with all EBV-reactivated patients having EBV-DNAemia and 1 patient in each group developing EBV-associated posttransplantation lymphoproliferative disorder (PTLD). Low EBV-DNA loads (> 5 × 102 to < 1 × 104 copies/mL) were more common in the LTV group (23% vs 10%, P = 0.01), while CMV reactivation was lower in the LTV group (35% vs. 56%, P = 0.002). No significant differences were found in neutrophil and platelet recovery, graft-vs-host disease, survival, relapse, or nonrelapse mortality.
Investigators concluded that increased EBV reactivation was associated with LTV prophylaxis for CMV after haploidentical HSCT.
Source: jhoonline.biomedcentral.com/articles/10.1186/s13045-024-01612-y
