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University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository

Specialty

Hematology/Oncology

Advisor

Dr. Thomas Colletti

Abstract

Purpose: The purpose of this article is to review the effects and management of the Cytomegalovirus (CMV) in allogeneic hematopoietic stem cell transplant (Allo-HSCT) patients and provide continuing medical education (CME) as well. The article will be a review for providers who manage Allo-HSCT patients and will offer new information for medical professionals that work in other specialties.

Method: An extensive literature search was conducted using PubMed, MEDLINE, and Google Scholar as the search databases. The terms Cytomegalovirus, CMV, allogeneic, and transplant were used to locate pertinent articles for review. There were eighteen applicable articles that were utilized for this literature review.

Results: There are articles that discuss CMV and the management in Allo-HSCT patients, but I did not find any in this search that were CME articles.

Conclusion: Cytomegalovirus (CMV) is a major cause of morbidity and mortality in allogeneic hematopoietic stem cell transplant (Allo-HSCT) patients. CMV can be associated with end-organ damage, increased non-relapse mortality, and decreased overall survival in Allo-HSCT patients. Prior to the approval of Letermovir by the FDA in 2017 as an antiviral prophylaxis, preemptive therapy was the standard of care for CMV infection by most transplant centers due to the toxicity of antivirals available at the time. Strict monitoring and highly sensitive lab assays are required for this method to be effective. Letermovir has significantly reduced CMV infection rates for Allo‐HSCT patients and now provides a safer option for antiviral prophylaxis. Educating healthcare providers on the effects of CMV in Allo-HSCT patients can help them management this patient population.

Keywords: Cytomegalovirus, CMV, allogeneic, transplant.

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