Letermovir Prophylaxis Decreases Burden of CMV in Patients at High Risk for CMV Disease Following Hematopoietic Cell Transplant

Abstract Despite effective therapies, CMV continues to have a significant impact on morbidity and mortality in hematopoietic cell transplant recipients. At particular risk are recipients of alternative grafts such as umbilical cord blood (UCB), haploidentical transplants (haplo), or patients conditioned with T-cell depleting regimens such as anti-thymocyte globulin (ATG). With the approval of letermovir, its impact on high risk patients is of particular interest. To evaluate the impact of letermovir prophylaxis at our center we performed a retrospective analysis of 114 high risk patients who received letermovir as prophylaxis (LET PPX) between January 2018 through December 2019, including 30 UCB and 22 haplo recipients, compared to 637 historical controls with comparable risk between January 2013 and December 2019. By D+100, letermovir prophylaxis significantly decreased the incidence of both CMV DNAemia compared to controls (45.37% vs 74.1%; P