Therapeutic strategies for cytomegalovirus in allogeneic hematopoietic cell transplantation.
Cytomegalovirus (CMV) remains a major cause of morbidity and mortality in allogeneic hematopoietic cell transplantation. Advances in surveillance of cytomegalovirus reactivation using sensitive techniques and a preemptive strategy to treat virus reactivation has reduced incidence of cytomegalovirus end organ disease. However, severe immunosuppression associated with extensive T-cell depletion resulting from graft-versus-host disease prevention for cases of mismatched or others such as haploidentical allogeneic hematopoietic cell transplantation (allo-HCT) and graft-versus-host disease therapy itself create clinical challenges in managing cytomegalovirus infection. Novel anticytomegalovirus therapies including newer pharmacologic interventions, vaccines, and adoptive cellular therapies to restore anticytomegalovirus immunity appear promising and are expected to continue to shape our treatment armamentarium. Eradication of CMV disease altogether, rather than simply suppressing viremia, should be the ultimate desirable goal.
Department of Blood & Marrow Transplantation, H Lee Moffitt Cancer Center, 12902 Magnolia Drive, FOB-3, Tampa, FL, USA.|Department of Oncologic Sciences, University of South Florida College of Medicine, Tampa, FL, USA.
Taiga
T
Nishihori
Section of Adult Hematology and Blood & Marrow Transplantation, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia.
Marwan
M
Shaheen
Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Jessica
J
El-Asmar
Section of Adult Hematology and Blood & Marrow Transplantation, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia.
Mahmoud
M
Aljurf
Department of Blood & Marrow Transplantation, H Lee Moffitt Cancer Center, 12902 Magnolia Drive, FOB-3, Tampa, FL, USA.|Department of Oncologic Sciences, University of South Florida College of Medicine, Tampa, FL, USA.
Mohamed A
MA
Kharfan-Dabaja
D000998:Antiviral Agents / Q000627:therapeutic use*; D003587:Cytomegalovirus / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000517:prevention & control*; D022482:Cytomegalovirus Vaccines / Q000627:therapeutic use*; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007165:Immunosuppression Therapy; D008212:Lymphocyte Depletion; D014184:Transplantation, Homologous; D014775:Virus Activation
D000998:Antiviral Agents; D022482:Cytomegalovirus Vaccines
CMV vaccine; adoptive cellular therapy; allogeneic hematopoietic cell transplantation; antiviral agent; cytomegalovirus