Letermovir Proven Safe and Efficacious for Preventing CMV Reactivation in Pediatric Patients Undergoing HSCT

Strategic Insights -

Pediatric patients undergoing hematopoietic stem cell transplant (HSCT) are at risk of developing cytomegalovirus (CMV) reactivation. A recent study published in the Transplantation and Cellular Therapy journal investigated the use of letermovir, a viral terminate inhibitor, for primary and secondary prophylaxis of CMV reactivation in pediatric patients. The study aimed to compare the incidence of CMV reactivation in a recent cohort of pediatric HSCT recipients receiving letermovir with a previous cohort of children receiving no prophylaxis.

Key Takeaways:

  • The study found that letermovir is safe and efficacious for preventing CMV reactivation in pediatric patients undergoing HSCT in both primary and secondary prophylaxis.
  • The incidence of CMV reactivation in the letermovir cohort was significantly lower compared to the no-prophylaxis cohort.
  • The risk of CMV reactivation was found to be higher among patients who were IgG seropositive, and letermovir prophylaxis reduced this risk.
  • The study suggests that letermovir is an effective and safe therapy for preventing CMV reactivation in pediatric patients undergoing HSCT.

Statistics:

  • The incidence of CMV reactivation in the letermovir cohort was 10.5% (95% CI, 3.8-21.5).
  • The incidence of CMV reactivation in the no-prophylaxis cohort was 39.1% (95% CI, 22.5-54.8).
  • The risk of CMV reactivation among IgG seropositive patients was 2.3 times higher (95% CI, 1.5-3.5).
  • Treatment-related mortality/overall survival is significantly improved with letermovir prophylaxis.

Sources:

  • Letermovir Primary and Secondary Prophylaxis in Pediatric Recipients of Allogeneic Haematopoietic Stem Cell Transplant. Transplantation and Cellular Therapy, 2025.
  • Paola De Lorenzo, et al. "Letermovir Primary and Secondary Prophylaxis in Pediatric Recipients of Allogeneic Haematopoietic Stem Cell Transplant." Transplantation and Cellular Therapy, vol. 2025, 2025.
  • NewsRx. Data on DNA Terminase Complex Inhibitors Reported by Paola De Lorenzo and Colleagues. Pediatrics Week, July 5, 2025, p. 137.