title: Combination therapy for multidrug-resistant cytomegalovirus disease.
abstract: Multidrug-resistant (MDR) cytomegalovirus (CMV) emerged after transient responses to ganciclovir, foscarnet, and cidofovir in a CMV-seropositive recipient who underwent allogeneic hematopoietic stem cell transplantation from a CMV-seronegative donor. Experimental treatments using leflunomide and artesunate failed. Re-transplantation from a CMV-seropositive donor supported by adoptive transfer of pp65-specific T cells and maribavir was followed by lasting suppression. This case illustrates that successful MDR CMV therapy may require individualized multidisciplinary approaches.
authors.affiliation: Infection Biology Laboratory, Department of Biomedicine, University and University Hospital of Basel, Basel, Switzerland.
authors.forename: C
authors.identifier: http://orcid.org/0000-0002-0926-3427
authors.initials: C
authors.lastname: Stuehler
authors.affiliation: Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Stüssi
authors.affiliation: Division of Hematology, Department of Biomedicine and Clinical Research, University Hospital of Basel, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Halter
authors.affiliation: Infection Biology Laboratory, Department of Biomedicine, University and University Hospital of Basel, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Nowakowska
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Schibli
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Battegay
authors.affiliation: Division of Hematology, Department of Biomedicine and Clinical Research, University Hospital of Basel, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Dirks
authors.affiliation: Division of Hematology, Department of Biomedicine and Clinical Research, University Hospital of Basel, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Passweg
authors.affiliation: Division of Hematology, Department of Biomedicine and Clinical Research, University Hospital of Basel, Basel, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Heim
authors.affiliation: Division of Hematology, Department of Biomedicine and Clinical Research, University Hospital of Basel, Basel, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Rovo
authors.affiliation: Division of Hematology, Department of Biomedicine and Clinical Research, University Hospital of Basel, Basel, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Kalberer
authors.affiliation: Division of Hematology, Department of Biomedicine and Clinical Research, University Hospital of Basel, Basel, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Bucher
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Weisser
authors.affiliation: Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Dumoulin
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland.|Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland.
authors.forename: H H
authors.initials: HH
authors.lastname: Hirsch
authors.affiliation: Infection Biology Laboratory, Department of Biomedicine, University and University Hospital of Basel, Basel, Switzerland.|Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Khanna
mesh_terms: D019264:Adoptive Transfer; D000998:Antiviral Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003586:Cytomegalovirus Infections / Q000276:immunology / Q000628:therapy*; D024921:Drug Resistance, Multiple, Viral; D004359:Drug Therapy, Combination; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged
chemical_list: D000998:Antiviral Agents
keywords: adoptive T-cell transfer; allogeneic hematopoietic stem cell transplantation; cytomegalovirus; maribavir; multidrug resistance