Refractory or resistant cytomegalovirus infections after hematopoietic stem cell transplantation: diagnosis and management

VernacularTitle:造血干细胞移植后难治性/耐药性巨细胞病毒感染诊疗进展
Author: Xiaoyu ZHANG ¹ ; Erlie JIANG
Author Information

1. 中国医学科学院血液病医院（中国医学科学院血液学研究所）北京协和医学院，血液与健康全国重点实验室，国家血液系统疾病临床医学研究中心，天津市血液病细胞治疗研究重点实验室，细胞生态海河实验室，天津　300020
Publication Type:Journal Article
From: Chinese Journal of Hematology 2024;45(11):1058-1064
CountryChina
Language:Chinese
Abstract: Cytomegalovirus (CMV) infection is one of the most prevalent opportunistic infections after hematopoietic stem cell transplantation (HSCT). Prophylaxis and preemptive therapy have demonstrated promise in reducing the incidence of CMV infection and CMV disease, but the management of refractory/resistant (R/R) CMV infections after HSCT remains a challenge that significantly affects the prognosis of patients undergoing HSCT. Intolerance and resistance to antivirals are the primary reasons for developing refractory CMV infections. CMV DNA quantification PCR combined with CMV-specific cell-mediated immunity monitoring may help to optimize diagnosis and enable personalized management of R/R CMV infection. Novel antiviral drugs and other immunotherapies, including intravenous immunoglobulin and adoptive CMV T cell therapy, constitute an appealing option.