Open AccessOff-Label Use of Letermovir as Preemptive Anti-Cytomegalovirus Therapy in a Pediatric Allogeneic Peripheral Blood Stem Cell Transplant
Author(s) -
Angela Chiereghin,
Tamara Belotti,
E Borgatti,
Nicola Fraccascia,
Giulia Piccirilli,
Maura Fois,
Massimo Borghi,
Gabriele Turello,
Liliana Gabrielli,
Riccardo Masetti,
Arcangelo Prete,
Stefano Fanti,
Tiziana Lazzarotto
Publication year - 2021
Publication title -
infection and drug resistance
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.033
H-Index - 39
ISSN - 1178-6973
DOI - 10.2147/idr.s296927
Subject(s) - foscarnet , cidofovir , medicine , ganciclovir , adverse effect , cytomegalovirus , viral load , immunology , clearance , stem cell , pharmacology , virology , human cytomegalovirus , virus , herpesviridae , viral disease , biology , urology , genetics
Despite the effectiveness of the currently available antiviral drugs in treating cytomegalovirus (CMV) infection, high rates of adverse effects are associated with their use. Moreover, a problem of increasing importance is the emergence of drug-resistant CMV infection. Here, we describe the first case of off-label use of letermovir (LMV) as preemptive antiviral therapy, in a pediatric allogeneic peripheral blood stem cell transplant recipient with ganciclovir-resistant CMV infection who was intolerant to foscarnet and unable to achieve viral clearance after seven doses of cidofovir. After the administration of LMV, a gradual reduction in viral load was observed and within 6 weeks of LMV treatment, after more than 6 months of positive CMV-DNAemia, the patient cleared the infection. No adverse effects associated with LMV were observed during treatment. In this pediatric study case, the off-label use of LMV for the treatment of CMV infection has been well tolerated and proved to be effective in leading to the suppression of viral replication.