Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

The role of interim-foscarnet prophylaxis in preventing cytomegalovirus infection after ex vivo αβ T cell-depleted haploidentical hematopoietic cell transplant in children

Bone Marrow Transplantation volume 56, pages 505–507 (2021)Cite this article

Subjects

Cytomegalovirus (CMV) infection is a common complication of hematopoietic stem cell transplantation because it can cause various end-organ diseases ranging from retinitis to fatal pneumonia or encephalitis [1]. It is also a major concern in the field of haploidentical hematopoietic cell transplantation (HHCT) [2]; however, prophylaxis of CMV infection in pediatric recipients of HHCT is unclear.

Often, ganciclovir (GCV) is used for pharmacologic prophylaxis of CMV [3]. To minimize adverse effects on the bone marrow during the periengraftment period, many clinical studies have used GCV as a “lead-in” strategy [4, 5]. Foscarnet (FCV) is also useful for prophylaxis; however, possible renal toxicity remains a limitation [4].

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Cumulative incidence of CMV reactivation according to prophylaxis group.

References

  1. Teira P, Battiwalla M, Ramanathan M, Barrett AJ, Ahn KW, Chen M, et al. Early cytomegalovirus reactivation remains associated with increased transplant-related mortality in the current era: a CIBMTR analysis. Blood. 2016;127:2427–38. https://doi.org/10.1182/blood-2015-11-679639.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Laberko A, Bogoyavlenskaya A, Shelikhova L, Shekhovtsova Z, Balashov D, Voronin K, et al. Risk factors for and the clinical impact of cytomegalovirus and Epstein-Barr virus infections in pediatric recipients of TCR-alpha/beta- and CD19-depleted grafts. Biol Blood Marrow Transpl. 2017;23:483–90. https://doi.org/10.1016/j.bbmt.2016.12.635.

    Article  Google Scholar 

  3. Boeckh M, Ljungman P. How we treat cytomegalovirus in hematopoietic cell transplant recipients. Blood. 2009;113:5711–9. https://doi.org/10.1182/blood-2008-10-143560.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Hammerstrom AE, Lombardi LR, Pingali SR, Rondon G, Chen J, Milton DR, et al. Prevention of cytomegalovirus reactivation in haploidentical stem cell transplantation. Biol Blood Marrow Transpl. 2018;24:353–8. https://doi.org/10.1016/j.bbmt.2017.09.018.

    Article  CAS  Google Scholar 

  5. Milano F, Pergam SA, Xie H, Leisenring WM, Gutman JA, Riffkin I, et al. Intensive strategy to prevent CMV disease in seropositive umbilical cord blood transplant recipients. Blood. 2011;118:5689–96. https://doi.org/10.1182/blood-2011-06-361618.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Im HJ, Koh KN, Suh JK, Lee SW, Choi ES, Jang S, et al. Haploidentical HCT using an alphabeta T-cell-depleted graft with targeted alphabeta(+) cells by add-back after a reduced intensity preparative regimen containing low-dose TBI. Bone Marrow Transpl. 2016;51:1217–22. https://doi.org/10.1038/bmt.2016.114.

    Article  CAS  Google Scholar 

  7. Ljungman P, Boeckh M, Hirsch HH, Josephson F, Lundgren J, Nichols G, et al. Definitions of cytomegalovirus infection and disease in transplant patients for use in clinical trials. Clin Infect Dis. 2017;64:87–91. https://doi.org/10.1093/cid/ciw668.

    Article  PubMed  Google Scholar 

  8. Stern L, Withers B, Avdic S, Gottlieb D, Abendroth A, Blyth E, et al. Human cytomegalovirus latency and reactivation in allogeneic hematopoietic stem cell transplant recipients. Front Microbiol. 2019;10:1186. https://doi.org/10.3389/fmicb.2019.01186.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Slobedman B, Mocarski ES. Quantitative analysis of latent human cytomegalovirus. J Virol. 1999;73:4806–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Goodrum F, Jordan CT, Terhune SS, High K, Shenk T. Differential outcomes of human cytomegalovirus infection in primitive hematopoietic cell subpopulations. Blood. 2004;104:687–95.

    Article  CAS  PubMed  Google Scholar 

  11. Doherty PC, Allan W, Eichelberger M, Carding SR. Roles of alpha beta and gamma delta T cell subsets in viral immunity. Annu Rev Immunol. 1992;10:123–51. https://doi.org/10.1146/annurev.iy.10.040192.001011.

    Article  CAS  PubMed  Google Scholar 

  12. Xia C-Q, Chernatynskaya AV, Wasserfall CH, Wan S, Looney BM, Eisenbeis S, et al. Anti-thymocyte globulin (ATG) differentially depletes naïve and memory T cells and permits memory-type regulatory T cells in nonobese diabetic mice. BMC Immunol. 2012;13:70. https://doi.org/10.1186/1471-2172-13-70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Sung Han Kang, Jae Won Yoo, Jin Kyung Seo, Hyery Kim, Kyung-Nam Koh, Eun Seok Choi, Jong Jin Seo & Ho Joon Im

  2. Department of Pediatrics, Chungnam National University Hospital, Daejon, Korea

    Jae Won Yoo

  3. Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Seongsoo Jang & Chan-Jeoung Park

Authors
  1. Sung Han Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jae Won Yoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jin Kyung Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hyery Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kyung-Nam Koh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eun Seok Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Seongsoo Jang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Chan-Jeoung Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jong Jin Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ho Joon Im
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ho Joon Im.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kang, S.H., Yoo, J.W., Seo, J.K. et al. The role of interim-foscarnet prophylaxis in preventing cytomegalovirus infection after ex vivo αβ T cell-depleted haploidentical hematopoietic cell transplant in children. Bone Marrow Transplant 56, 505–507 (2021). https://doi.org/10.1038/s41409-020-01020-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41409-020-01020-z

Search

Advanced search

Quick links