Real-world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation: a single center observational study

ObjectivesTo compare the efficacy and safety of letermovir and ganciclovir for cytomegalovirus (CMV) prophylaxis in adolescent patients (aged 14-17 years) undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT).MethodsThis observational and single-center study collected data from Fe...

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Main Authors: Ziwei Xu, Xuan Lu, Huafang Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2025.1558637/full
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author Ziwei Xu
Xuan Lu
Huafang Wang
author_facet Ziwei Xu
Xuan Lu
Huafang Wang
author_sort Ziwei Xu
collection DOAJ
description ObjectivesTo compare the efficacy and safety of letermovir and ganciclovir for cytomegalovirus (CMV) prophylaxis in adolescent patients (aged 14-17 years) undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT).MethodsThis observational and single-center study collected data from February 2023 and April 2024.ResultsThe cumulative incidence of CMV DNAemia following HSCT was 44.4% in the letermovir group (n=20) and 66.3% in the control group (n=32) receiving ganciclovir. Notably, the cumulative incidence of clinically significant CMV infection (csCMVi) was significantly reduced in the letermovir group compared with control patients (11.0% vs 41.3%, p=0.021). Among patients diagnosed with grades II-IV acute graft-versus-host disease (aGVHD), a significantly lower proportion of individuals in the letermovir group presented CMV DNAemia than in the control group (20.0% vs 73.3%, p=0.013). The common adverse events observed in the letermovir group were aGVHD (60.0%), diarrhea (25.0%), and nausea (15.0%). Leukopenia was reported in only one patient, and did not necessitate an adjustment of letermovir dosage.ConclusionsIn this single-center real-world study, letermovir exhibited a favourable efficacy and safety profile for CMV prophylaxis in adolescent patients undergoing HSCT. However, further prospective multi-center studies are warranted to validate our conclusion in adolescent patients.
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spelling doaj-art-f070a9b3d08049b5b0553f28a96f2fe82025-08-20T03:46:47ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-06-011510.3389/fcimb.2025.15586371558637Real-world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation: a single center observational studyZiwei XuXuan LuHuafang WangObjectivesTo compare the efficacy and safety of letermovir and ganciclovir for cytomegalovirus (CMV) prophylaxis in adolescent patients (aged 14-17 years) undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT).MethodsThis observational and single-center study collected data from February 2023 and April 2024.ResultsThe cumulative incidence of CMV DNAemia following HSCT was 44.4% in the letermovir group (n=20) and 66.3% in the control group (n=32) receiving ganciclovir. Notably, the cumulative incidence of clinically significant CMV infection (csCMVi) was significantly reduced in the letermovir group compared with control patients (11.0% vs 41.3%, p=0.021). Among patients diagnosed with grades II-IV acute graft-versus-host disease (aGVHD), a significantly lower proportion of individuals in the letermovir group presented CMV DNAemia than in the control group (20.0% vs 73.3%, p=0.013). The common adverse events observed in the letermovir group were aGVHD (60.0%), diarrhea (25.0%), and nausea (15.0%). Leukopenia was reported in only one patient, and did not necessitate an adjustment of letermovir dosage.ConclusionsIn this single-center real-world study, letermovir exhibited a favourable efficacy and safety profile for CMV prophylaxis in adolescent patients undergoing HSCT. However, further prospective multi-center studies are warranted to validate our conclusion in adolescent patients.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1558637/fulladolescentscytomegalovirusletermovirganciclovirHSCThematopoietic stem cell transplant
spellingShingle Ziwei Xu
Xuan Lu
Huafang Wang
Real-world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation: a single center observational study
Frontiers in Cellular and Infection Microbiology
adolescents
cytomegalovirus
letermovir
ganciclovir
HSCT
hematopoietic stem cell transplant
title Real-world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation: a single center observational study
title_full Real-world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation: a single center observational study
title_fullStr Real-world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation: a single center observational study
title_full_unstemmed Real-world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation: a single center observational study
title_short Real-world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation: a single center observational study
title_sort real world efficacy and safety of letermovir versus ganciclovir prophylaxis in adolescent patients undergoing allogenic hematopoietic stem cell transplantation a single center observational study
topic adolescents
cytomegalovirus
letermovir
ganciclovir
HSCT
hematopoietic stem cell transplant
url https://www.frontiersin.org/articles/10.3389/fcimb.2025.1558637/full
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AT huafangwang realworldefficacyandsafetyofletermovirversusganciclovirprophylaxisinadolescentpatientsundergoingallogenichematopoieticstemcelltransplantationasinglecenterobservationalstudy