Manuela Spadea, Assistant Professor of Pediatrics at University of Turin, shared a post on LinkedIn about a recent article she and her colleagues co-authored, adding:
“New paper out: Letermovir prophylaxis in children after allo-HCT
We explored a very practical question: does letermovir affect early immune recovery—and how does it reshape post-transplant viral infections?
What we found (propensity score–matched cohorts, 81 LET vs 81 PET):
- Immune reconstitution was not hindered — T, B and NK-cell subset counts were comparable at day +60 and +100.
- CMV burden was markedly lower — day +90 clinically significant CMV 11.1% vs 42%, and no CMV disease with letermovir.
- The viral landscape shifted — fewer multiple infections (5 vs 17), later viral disease onset (58 vs 30 days), but adenovirus was more frequent (8 vs 0) and we observed an EBV-PTLD signal (2 cases) that warrants careful surveillance.
Take-home: In this pediatric real-world cohort, letermovir appears immunologically safe at early landmarks, strongly reduces CMV, and reinforces the need for close monitoring of non-CMV viruses during prophylaxis.
A huge thank you to all my coauthors and the teams across the participating centers—this work was truly collaborative:
If you work in pediatric transplant care: how are you monitoring ADV/EBV during LET prophylaxis in your center?”
Title: Letermovir Prophylaxis Does Not Hinder Immune Reconstitution While Reshaping Viral Infection Landscape in Children
Authors: Manuela Spadea, Francesca Romani, Silvia Nucera, Alessio Tomatis, Raffaele Vitale, Viola Carzaniga, Francesco Baccelli, Alessandro Di Gangi, Francesca Dagliano, Vincenzo Apolito, Valeria Ceolin, Francesca Gottardi, Francesco Saglio, Mariacristina Menconi, Riccardo Masetti, Maura Faraci, Adriana Balduzzi, Franca Fagioli
Read the Full Article on Transplantation and Cellular Therapy
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