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Cytotect®CP as salvage therapy in patients with CMV infection following allogeneic hematopoietic cell transplantation: a multicenter retrospective study

Bone Marrow Transplantation volume 53, pages 1328–1335 (2018)Cite this article

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Abstract

Cytomegalovirus is one of the main contributing factors to high mortality rates in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). The main factors of treatment failure are both drug resistance and intolerance. In some cases, Cytotect®CP CMV-hyperimmune globulin is used as salvage therapy. This study aims to investigate the safety and efficacy of Cytotect®CP as a salvage therapy in patients with CMV infection after allo-HCT. Twenty-three consecutive patients received Cytotect®CP for CMV infection after prior CMV therapy. At the time of Cytotect®CP introduction, 17 patients (74%) had developed acute GVHD and 15 patients (64%) were receiving steroid treatment; Cytotect®CP was used as monotherapy (n = 7) and in combination (n = 16). Overall, response was observed in 18 patients (78%) with a median time of 15 days (range: 3–51). Of the 18 responders, 4 experienced CMV reactivation, while 5 responders died within 100 days of beginning treatment. Of these 5 deaths, 4 were due to causes unrelated to CMV. Estimated 100-day OS from the introduction of Cytotect®CP was 69.6%. No statistically significant difference was observed in 100-day OS between responders and non-responders (73.7% vs 50.0%, p = 0.258). Cytotect®CP as salvage therapy is effective and well-tolerated. Given its safety profile, early treatment use should be considered.

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Acknowledgements

The authors would like to thank all patients and donors included in this study. They would also like to thank Rachel Tipton for English copyediting help. Ibrahim Yakoub-Agha would like to thank the association “Immunologie de l’allogreffe” for their helps in his research.

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Authors and Affiliations

  1. Maladies du sang, CHRU de Lille, 59037, Lille, France

    Tamim Alsuliman, Caroline Kitel & Ibrahim Yakoub-Agha

  2. Service d’Hématologie, CH de Boulogne, 62321, Boulogne sur mer, France

    Tamim Alsuliman

  3. Service d’Hématologie, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie (UPMC), 75012, Paris, France

    Rémy Dulery

  4. Service d’Hématologie, CHU de Nantes, 44093, Nantes, Cedex 1, France

    Thierry Guillaume

  5. Service d’Hématologie, CHU de Besançon, 25030, Besançon, France

    Fabrice Larosa

  6. Service d’Hématologie, IC Loire, 42270, Saint-Priest-en-Jarez, France

    Jérôme Cornillon

  7. Service d’Hématologie, CHU de Lyon, 69002, Lyon, France

    Helene Labussière-Wallet

  8. Hôpital Haut Léveque, avenue Magellan, 36000, Pessac, France

    Clémence Médiavilla

  9. Institut de pharmacie, CHRU de Lille, 59037, Lille, France

    Stéphanie Belaiche

  10. Service d’Hématologie, CHU de Montpellier, 34295, Montpellier, cedex 5, France

    Jeremy Delage

  11. National Reference Center for Herpes viruses, Inserm U1092, Université de Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, CHU de Limoges, Limoges, France

    Sophie Alain

  12. CHU de Lille, LIRIC, INSERM U995, université de Lille2, 59000, Lille, France

    Ibrahim Yakoub-Agha

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  1. Tamim Alsuliman
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Correspondence to Ibrahim Yakoub-Agha.

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Conflict of interest

IYA received honorarium from Biotest, the company that commercialize Cytotect®CP. Biotest has also provided grant for this study. The remaining authors declare that they have no conflict of interest.

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Alsuliman, T., Kitel, C., Dulery, R. et al. Cytotect®CP as salvage therapy in patients with CMV infection following allogeneic hematopoietic cell transplantation: a multicenter retrospective study. Bone Marrow Transplant 53, 1328–1335 (2018). https://doi.org/10.1038/s41409-018-0166-9

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