2  CMV infection

2.1 CMV disease vs reactivation

2.2 CMV prophylaxis

  • T-cell lymphomas, especially alemtuzumab therapies

2.3 Treatment agents

2.3.1 Valganciclovir

  • Myelosupression

2.3.2 Ganciclovir

  • Myelosupression

2.3.3 Foscarnet

  • Approach electrolyte and renal monitoring and management

2.4 Treatment-resistant CMV

2.4.1 Maribavir

  • AURORA trial: a randomized controlled trial comparing maribavir to valganciclovir for pre-emptive CMV therapy post allogeneic transplant.
  • AURORA RCT of – maribavir did not meet non-inferiority in terms of CMV clearance at week 8; less cytopenias and more GI tox than valgan
  • Maribavir resistance mutations

2.4.2 Letermovir

  • NEJM publication (Marty et al. 2017) : A Double-blind placebo-controlled RCT of letermovir prophylaxis in post allo prophylaxis

2.5 CAR T-cell therapies and T-cell engaging bispecific antibodies