Current and future options for cytomegalovirus reactivation in hematopoietic cell transplantation patients

Abstract

Report from the 43rd Annual Meeting of the European Society for Blood & Marrow Transplantation 2017, 26–29 March 2017, Marseille, France Cytomegalovirus (CMV) reactivation is a potentially life-threatening complication in immunocompromised recipients of hematopoietic cell transplantation (HCT). Its management was therefore a key topic for over 5000 delegates from 85 countries attending the 43rd Annual Meeting of the European Society for Blood & Marrow Transplantation 2017. The currently available anti-CMV armamentarium is seldom used to prevent CMV reactivation due to the associated myelosuppression and renal toxicity. Following HCT, CMV reactivation is generally managed pre-emptively using sensitive assays for early detection of viral DNA (and to a lesser extent antigenemia) and, where necessary, treatment with antiviral drugs with the aim of preventing CMV disease. However, any degree of CMV reactivation increases the risk of mortality, and novel antiviral therapies may offer the possibility of prophylaxis to prevent CMV reactivation and improve survival after HCT.