Combination therapy for multidrug‐resistant cytomegalovirus disease

Multidrug‐resistant (MDR) cytomegalovirus (CMV) emerged after transient responses to ganciclovir, foscarnet, and cidofovir in a CMV‐seropositive recipient who underwent allogeneic hematopoietic stem cell transplantation from a CMV‐seronegative donor. Experimental treatments using leflunomide and art...

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Bibliographic Details
Published in:Transplant infectious disease 2015-10, Vol.17 (5), p.751-755
Main Authors: Stuehler, C., Stüssi, G., Halter, J., Nowakowska, J., Schibli, A., Battegay, M., Dirks, J., Passweg, J., Heim, D., Rovo, A., Kalberer, C., Bucher, C., Weisser, M., Dumoulin, A., Hirsch, H.H., Khanna, N.
Format: Article
Language:English
Subjects:
Adoptive Transfer
adoptive T‐cell transfer
allogeneic hematopoietic stem cell transplantation
Antiviral Agents - therapeutic use
Combined Modality Therapy
Cytomegalovirus
Cytomegalovirus Infections - immunology
Cytomegalovirus Infections - therapy
Drug Resistance, Multiple, Viral
Drug Therapy, Combination
Hematopoietic Stem Cell Transplantation
Humans
Immunocompromised Host
Male
maribavir
Middle Aged
multidrug resistance
Transplants & implants
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Summary:Multidrug‐resistant (MDR) cytomegalovirus (CMV) emerged after transient responses to ganciclovir, foscarnet, and cidofovir in a CMV‐seropositive recipient who underwent allogeneic hematopoietic stem cell transplantation from a CMV‐seronegative donor. Experimental treatments using leflunomide and artesunate failed. Re‐transplantation from a CMV‐seropositive donor supported by adoptive transfer of pp65‐specific T cells and maribavir was followed by lasting suppression. This case illustrates that successful MDR CMV therapy may require individualized multidisciplinary approaches.
ISSN:1398-2273
1399-3062
DOI:10.1111/tid.12435