Use of Letermovir for Salvage Therapy for Resistant Cytomegalovirus in a Pediatric Hematopoietic Stem Cell Transplant Recipient.

Abstract

We present here the first published use of letermovir for the treatment of resistant cytomegalovirus (CMV) in a pediatric patient. A 14-year-old girl underwent a double unrelated umbilical cord blood transplantation to treat her sickle cell disease (hemoglobin SS) and developed ganciclovir-resistant CMV DNAemia with end-organ involvement that was treated successfully with a combination of foscarnet and letermovir. After she was transitioned to letermovir monotherapy for secondary prophylaxis, she developed recurrent DNAemia with laboratory-confirmed ganciclovir, foscarnet, and letermovir resistance.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1093/jpids/piz050

Publication Info

Kilgore, Jacob T, Bradford Becken, Matthew G Varga, Suhag Parikh, Vinod Prasad, Debra Lugo and Yeh-Chung Chang (2019). Use of Letermovir for Salvage Therapy for Resistant Cytomegalovirus in a Pediatric Hematopoietic Stem Cell Transplant Recipient. Journal of the Pediatric Infectious Diseases Society. 10.1093/jpids/piz050 Retrieved from https://hdl.handle.net/10161/20674.

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Scholars@Duke

Kilgore

Jacob T Kilgore

Clinical Associate in the Department of Pediatrics
Prasad

Vinod K. Prasad

Consulting Professor in the Department of Pediatrics

1. Expanding the role of umbilical cord blood transplants for inherited metabolic disorders.
2. Impact of histocompatibility and other determinants of alloreactivity on clinical outcomes of unrelated cord blood transplants.
3. Studies to analyse the impact of Killer Immunoglobulin receptors on the outcomes of hematopoietic stem cell transplantation utilizing haploidentical, CD34 selected, familial grafts.
4. Propective longitudinal study of serial monitoring of adenovirus in allogenic transpants(SMAART)patients.
5. Use of mesenchymal stem cells for the treatment of GVHD

Lugo

Debra Lugo

Assistant Professor of Pediatrics
Chang

Yeh-Chung Chang

Assistant Professor of Pediatrics

My interests include infections in immunocompromised hosts and I help run the Pediatric Transplant ID clinical service. At Duke, these populations include pediatric solid organ transplant recipients, bone marrow transplant recipients, and Oncology patients. My personal research includes EBV infection and post-transplant lymphoprolifeartive disease (PTLD), as well as vaccine responses in the immunocompromised host populations. I am also involved in studies evaluating invasive fungal infections and pharmacokinetics of antifungal medications.


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