Efficacy and safety of adoptive T-cell therapy in treating cytomegalovirus infections post-haematopoietic stem cell transplantation: A systematic review and meta-analysis.

Publisher: Wiley Country of Publication: England NLM ID: 9112448 Publication Model: Print Cited Medium: Internet ISSN: 1099-1654 (Electronic) Linking ISSN: 10529276 NLM ISO Abbreviation: Rev Med Virol Subsets: MEDLINE

Original Publication: Chichester, West Sussex, England : Wiley, c1991-

Cytomegalovirus Infections*/immunology ; Cytomegalovirus Infections*/therapy ; Cytomegalovirus Infections*/virology ; Hematopoietic Stem Cell Transplantation*/adverse effects ; Hematopoietic Stem Cell Transplantation*/methods ; T-Lymphocytes*/immunology; Humans ; Treatment Outcome ; Immunotherapy, Adoptive/methods ; Immunotherapy, Adoptive/adverse effects ; Cytomegalovirus/immunology ; Transplantation, Homologous/adverse effects

Cytomegalovirus (CMV) infection poses significant risks in allogeneic haematopoietic stem cell transplant (allo-HSCT) recipients. Despite advances in antiviral therapies, issues such as drug resistance, side effects, and inadequate immune reconstitution remain. This systematic review and meta-analysis aim to evaluate the efficacy and safety of adoptive cell therapy (ATC) in managing CMV infections in allo-HSCT recipients. Adhering to preferred reporting items for systematic reviews and meta-analyses guidelines, we conducted a comprehensive database search through July 2023. A systematic review and meta-analysis were conducted on studies involving HSCT patients with CMV infections treated with ATC. The primary outcome was the response rate to ATC, and secondary outcomes included adverse events associated with ATC. The Freeman-Tukey transformation was applied for analysis. In the meta-analysis of 40 studies involving 953 participants, ATC achieved an overall integrated response rate of 90.16%, with a complete response of 82.59% and a partial response of 22.95%. ATC source, HLA matching, steroid intake, and age group markedly influenced response rates. Donor-derived T-cell treatments exhibited a higher response rate (93.66%) compared to third-party sources (88.94%). HLA-matched patients demonstrated a response rate of 92.90%, while mismatched patients had a lower rate. Children showed a response rate of 83.40%, while adults had a notably higher rate of 98.46%. Adverse events were minimal, with graft-versus-host disease occurring in 24.32% of patients. ATC shows promising response rates in treating CMV infections post-HSCT, with an acceptable safety profile. However, to establish its efficacy conclusively and compare it with other antiviral treatments, randomised controlled trials are essential. Further research should prioritise such trials over observational and one-arm studies to provide robust evidence for clinical decision-making.
(© 2024 John Wiley & Sons Ltd.)

Broers AE, vander Holt R, van Esser JW, et al. Increased transplant‐related morbidity and mortality in CMV‐seropositive patients despite highly effective prevention of CMV disease after allogeneic T‐cell‐depleted stem cell transplantation. Blood. 2000;95(7):2240‐2245. https://doi.org/10.1182/blood.v95.7.2240.007k08_2240_2245.
Cho SY, Ar MC, Machado CM, et al. Epidemiology, treatment patterns, and disease burden of cytomegalovirus in hematopoietic cell transplant recipients in selected countries outside of Europe and North America: a systematic review. Transpl Infect Dis. 2023;25(4):e14083. https://doi.org/10.1111/tid.14083.
Acar K, Akı SZ, Ozkurt ZN, Bozdayı G, Rota S, Türköz Sucak G. Factors associated with cytomegalovirus reactivation following allogeneic hematopoietic stem cell transplantation: human leukocyte antigens might be among the risk factors. Turk J Haematol. 2014;31(3):276‐285. https://doi.org/10.4274/tjh.2013.0244.
Cho SY, Lee DG, Kim HJ. Cytomegalovirus infections after hematopoietic stem cell transplantation: current status and future immunotherapy. Int J Mol Sci. 2019;20(11):2666. https://doi.org/10.3390/ijms20112666.
Ouellette CP. Adoptive immunotherapy for prophylaxis and treatment of cytomegalovirus infection. Viruses. 2022;14(11):2370. https://doi.org/10.3390/v14112370.
Ljungman P, de la Camara R, Robin C, et al. Guidelines for the management of cytomegalovirus infection in patients with haematological malignancies and after stem cell transplantation from the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis. 2019;19(8):e260‐e272. https://doi.org/10.1016/s1473‐3099(19)30107‐0.
Sadowska‐Klasa A, Leisenring WM, Limaye AP, Boeckh M. Cytomegalovirus viral load threshold to guide preemptive therapy in hematopoietic cell transplant recipients: correlation with CMV disease. J Infect Dis. 2024;229(5):1435‐1439.
Märtson AG, Edwina AE, Burgerhof JGM, et al. Ganciclovir therapeutic drug monitoring in transplant recipients. J Antimicrob Chemother. 2021;76(9):2356‐2363. https://doi.org/10.1093/jac/dkab195.
Heston SM, Young RR, Tanaka JS, et al. Risk factors for CMV viremia and treatment‐associated adverse events among pediatric hematopoietic stem cell transplant recipients. Open Forum Infect Dis. 2022;9(2):ofab639. https://doi.org/10.1093/ofid/ofab639.
Mehta Steinke SA, Alfares M, Valsamakis A, et al. Outcomes of transplant recipients treated with cidofovir for resistant or refractory cytomegalovirus infection. Transpl Infect Dis. 2021;23(3):e13521. https://doi.org/10.1111/tid.13521.
Chemaly RF, Chou S, Einsele H, et al. Definitions of resistant and refractory cytomegalovirus infection and disease in transplant recipients for use in clinical trials. Clin Infect Dis. 2019;68(8):1420‐1426. https://doi.org/10.1093/cid/ciy696.
Liu J, Kong J, Chang YJ, et al. Patients with refractory cytomegalovirus (CMV) infection following allogeneic haematopoietic stem cell transplantation are at high risk for CMV disease and non‐relapse mortality. Clin Microbiol Infect. 2015;21(12):1121.e9‐15. https://doi.org/10.1016/j.cmi.2015.06.009.
Hantz S, Garnier‐Geoffroy F, Mazeron MC, et al. Drug‐resistant cytomegalovirus in transplant recipients: a French cohort study. J Antimicrob Chemother. 2010;65(12):2628‐2640. https://doi.org/10.1093/jac/dkq368.
Papanicolaou GA, Silveira FP, Langston AA, et al. Maribavir for refractory or resistant cytomegalovirus infections in hematopoietic‐cell or solid‐organ transplant recipients: a randomized, dose‐ranging, double‐blind, phase 2 study. Clin Infect Dis. 2019;68(8):1255‐1264. https://doi.org/10.1093/cid/ciy706.
Gandhi RG, Kotton CN. Evaluating the safety of Maribavir for the treatment of cytomegalovirus. Therapeut Clin Risk Manag. 2022;18:223‐232. https://doi.org/10.2147/tcrm.s303052.
Avery RK, Alain S, Alexander BD, et al. Maribavir for refractory cytomegalovirus infections with or without resistance post‐transplant: results from a phase 3 randomized clinical trial. Clin Infect Dis. 2022;75(4):690‐701. https://doi.org/10.1093/cid/ciab988.
Kleiboeker HL, Descourouez JL, Schulz LT, et al. Maribavir for the management of cytomegalovirus in adult transplant recipients: a review of the literature and practical considerations. Ann Pharmacother. 2023;57(5):597‐608. https://doi.org/10.1177/10600280221118959.
Roddie C, Peggs KS. Immunotherapy for transplantation‐associated viral infections. J Clin Invest. 2017;127(7):2513‐2522. https://doi.org/10.1172/jci90599.
Leen AM, Heslop HE, Brenner MK. Antiviral T‐cell therapy. Immunol Rev. 2014;258(1):12‐29. https://doi.org/10.1111/imr.12138.
Koehne G, Hasan A, Doubrovina E, et al. Immunotherapy with donor T cells sensitized with overlapping pentadecapeptides for treatment of persistent cytomegalovirus infection or viremia. Biol Blood Marrow Transplant. 2015;21(9):1663‐1678. https://doi.org/10.1016/j.bbmt.2015.05.015.
Fabrizio VA, Rodriguez‐Sanchez MI, Mauguen A, et al. Adoptive therapy with CMV‐specific cytotoxic T lymphocytes depends on baseline CD4+ immunity to mediate durable responses. Blood Adv. 2021;5(2):496‐503. https://doi.org/10.1182/bloodadvances.2020002735.
Kaeuferle T, Krauss R, Blaeschke F, Willier S, Feuchtinger T. Strategies of adoptive T ‐cell transfer to treat refractory viral infections post allogeneic stem cell transplantation. J Hematol Oncol. 2019;12(1):13. https://doi.org/10.1186/s13045‐019‐0701‐1.
DerSimonian R, Laird N. Meta‐analysis in clinical trials. Contr Clin Trials. 1986;7(3):177‐188. https://doi.org/10.1016/0197‐2456(86)90046‐2.
Anscombe FJ. The transformation of Poisson, binomial and negative‐binomial data. Biometrika. 1948;35(3/4):246‐254. https://doi.org/10.2307/2332343.
Berkson J. Application of the logistic function to bio‐assay. J Am Stat Assoc. 1944;39(227):357‐365. https://doi.org/10.2307/2280041.
Freeman MF, Tukey JW. Transformations related to the angular and the square root. Ann Math Stat. 1950;21(4):607‐611. https://doi.org/10.1214/aoms/1177729756.
Pettigrew HM, Gart JJ, Thomas DG. The bias and higher cumulants of the logarithm of a binomial variate. Biometrika. 1986;73(2):425‐435. https://doi.org/10.1093/biomet/73.2.425.
Schwarzer G, Chemaitelly H, Abu‐Raddad LJ, Rücker G. Seriously misleading results using inverse of Freeman‐Tukey double arcsine transformation in meta‐analysis of single proportions. Res Synth Methods. 2019;10(3):476‐483. https://doi.org/10.1002/jrsm.1348.
Doi SA, Xu C. The Freeman‐Tukey double arcsine transformation for the meta‐analysis of proportions: recent criticisms were seriously misleading. J Evid Base Med. 2021;14(4):259‐261. https://doi.org/10.1111/jebm.12445.
Furuya‐Kanamori L, Barendregt JJ, Doi SAR. A new improved graphical and quantitative method for detecting bias in meta‐analysis. Int J Evid Base Healthc. 2018;16(4):195‐203. https://doi.org/10.1097/xeb.0000000000000141.
Nyaga VN, Arbyn M, Aerts M. Metaprop: a Stata command to perform meta‐analysis of binomial data. Arch Publ Health. 2014;72:1‐10. https://doi.org/10.1186/2049‐3258‐72‐39.
Furuya‐Kanamori L. LFK: Stata module to compute LFK index and Doi plot for detection of publication bias in meta‐analysis. 2021.
Walter EA, Greenberg PD, Gilbert MJ, et al. Reconstitution of cellular immunity against cytomegalovirus in recipients of allogeneic bone marrow by transfer of T‐cell clones from the donor. N Engl J Med. 1995;333(16):1038‐1044. https://doi.org/10.1056/nejm199510193331603.
Einsele H, Roosnek E, Rufer N, et al. Infusion of cytomegalovirus (CMV)‐specific T cells for the treatment of CMV infection not responding to antiviral chemotherapy. Blood. 2002;99(11):3916‐3922. https://doi.org/10.1182/blood.v99.11.3916.
Peggs KS, Mackinnon S. Augmentation of virus‐specific immunity after hematopoietic stem cell transplantation by adoptive T‐cell therapy. Hum Immunol. 2004;65(5):550‐557. https://doi.org/10.1016/j.humimm.2004.02.016.
Cobbold M, Khan N, Pourgheysari B, et al. Adoptive transfer of cytomegalovirus‐specific CTL to stem cell transplant patients after selection by HLA‐peptide tetramers. J Exp Med. 2005;202(3):379‐386. https://doi.org/10.1084/jem.20040613.
Filicko‐O'Hara J, Grosso D, Flomenberg PR, et al. Antiviral responses following L‐leucyl‐L‐leucine methyl esther (LLME)‐treated lymphocyte infusions: graft‐versus‐infection without graft‐versus‐host disease. Biol Blood Marrow Transplant. 2009;15(12):1609‐1619. https://doi.org/10.1016/j.bbmt.2009.08.020.
Peggs KS, Verfuerth S, Pizzey A, Chow SL, Thomson K, Mackinnon S. Cytomegalovirus‐specific T cell immunotherapy promotes restoration of durable functional antiviral immunity following allogeneic stem cell transplantation. Clin Infect Dis. 2009;49(12):1851‐1860. https://doi.org/10.1086/648422.
Dong L, Gao ZY, Chang LJ, et al. Adoptive transfer of cytomegalovirus/Epstein‐Barr virus‐specific immune effector cells for therapeutic and preventive/preemptive treatment of pediatric allogeneic cell transplant recipients. J Pediatr Hematol Oncol. 2010;32(1):e31‐e37. https://doi.org/10.1097/mph.0b013e3181bf5e2d.
Feuchtinger T, Opherk K, Bethge WA, et al. Adoptive transfer of pp65‐specific T cells for the treatment of chemorefractory cytomegalovirus disease or reactivation after haploidentical and matched unrelated stem cell transplantation. Blood. 2010;116(20):4360‐4367. https://doi.org/10.1182/blood‐2010‐01‐262089.
Leen AM, Bollard CM, Mendizabal AM, et al. Most closely HLA‐matched allogeneic virus specific cytotoxic T‐lymphocytes (CTL) to treat persistent reactivation or infection with adenovirus, CMV and EBV after hemopoietic stem cell transplantation (HSCT). Blood. 2010;116(21):829. https://doi.org/10.1182/blood.v116.21.829.829.
Peggs KS, Thomson K, Samuel E, et al. Directly selected cytomegalovirus‐reactive donor T cells confer rapid and safe systemic reconstitution of virus‐specific immunity following stem cell transplantation. Clin Infect Dis. 2011;52(1):49‐57. https://doi.org/10.1093/cid/ciq042.
Bao L, Cowan MJ, Dunham K, et al. Adoptive immunotherapy with CMV‐specific cytotoxic T lymphocytes for stem cell transplant patients with refractory CMV infections. J Immunother. 2012;35(3):293‐298. https://doi.org/10.1097/cji.0b013e31824300a2.
Hanley PJ, Martinez C, Leung K, et al. Improving immune reconstitution after cord blood transplantation using ex vivo expanded virus‐specific T cells: a phase I clinical study. Blood. 2012;120(21):224. https://doi.org/10.1182/blood.v120.21.224.224.
Leen AM, Bollard CM, Mendizabal AM, et al. Multicenter study of “off‐the‐shelf” third party virus‐specific T cells (VSTs) to treat adenovirus (ADV), cytomegalovirus (CMV) or Epstein Barr virus (EBV) infection after hemopoietic stem cell transplantation (HSCT). Blood. 2012;120(21):457. https://doi.org/10.1182/blood.v120.21.457.457.
Meij P, Jedema I, Zandvliet ML, et al. Effective treatment of refractory CMV reactivation after allogeneic stem cell transplantation with in vitro‐generated CMV pp65‐specific CD8+ T‐cell lines. J Immunother. 2012;35(8):621‐628. https://doi.org/10.1097/cji.0b013e31826e35f6.
Uhlin M, Gertow J, Uzunel M, et al. Rapid salvage treatment with virus‐specific T cells for therapy‐resistant disease. Clin Infect Dis. 2012;55(8):1064‐1073. https://doi.org/10.1093/cid/cis625.
Blyth E, Clancy L, Simms R, et al. Donor‐derived CMV‐specific T cells reduce the requirement for CMV‐directed pharmacotherapy after allogeneic stem cell transplantation. Blood. 2013;121(18):3745‐3758. https://doi.org/10.1182/blood‐2012‐08‐448977.
Gerdemann U, Katari UL, Papadopoulou A, et al. Safety and clinical efficacy of rapidly‐generated trivirus‐directed T cells as treatment for adenovirus, EBV, and CMV infections after allogeneic hematopoietic stem cell transplant. Mol Ther. 2013;21(11):2113‐2121. https://doi.org/10.1038/mt.2013.151.
Leen AM, Bollard CM, Mendizabal AM, et al. Multicenter study of banked third‐party virus‐specific T cells to treat severe viral infections after hematopoietic stem cell transplantation. Blood. 2013;121(26):5113‐5123. https://doi.org/10.1182/blood‐2013‐02‐486324.
Papadopoulou A, Katari UL, Gerdemann U, et al. Safety and clinical efficacy of rapidly‐generated virus‐specific T cells with activity against Adv, EBV, CMV, HHV6 and BK virus administered after allogeneic hematopoietic stem cell transplant. Blood. 2013;122(21):148. https://doi.org/10.1182/blood.v122.21.148.148.
Clancy LE, Blyth E, Withers B, et al. Therapeutic infusion of partially HLA‐matched third‐party virus‐specific T cells in HSCT patients with refractory viral infection. Blood. 2014;124(21):3835. https://doi.org/10.1182/blood.v124.21.3835.3835.
Koehne G, Hasan A, Doubrovina E, et al. Immunotherapy with donor T cells sensitized with overlapping pentadecapeptides for treatment of persistent cytomegalovirus infection or viremia. Biol Blood Marrow Transplant. 2015;21(9):1663‐1678. https://doi.org/10.1016/j.bbmt.2015.05.015.
Withers B, Blyth E, Clancy L, et al. Third‐party donor virus‐specific t cells are efficacious in the treatment of refractory viral infection following allogeneic HSCT, but may not persist post‐infusion. Blood. 2015;126(23):623. https://doi.org/10.1182/blood.v126.23.623.623.
Omer B, Papadopoulou A, Koottiyaniyil N, et al. Administration of most closely HLA‐matched multivirus‐specific t cells for the treatment of EBV, CMV, ADV, HHV6, and BKV post allogeneic hematopoietic stem cell transplant. Blood. 2015;126(23):622. https://doi.org/10.1182/blood.v126.23.622.622.
Naik S, Nicholas SK, Martinez CA, et al. Adoptive immunotherapy for primary immunodeficiency disorders with virus‐specific T lymphocytes. J Allergy Clin Immunol. 2016;137(5):1498‐1505.e1. https://doi.org/10.1016/j.jaci.2015.12.1311.
Neuenhahn M, Albrecht J, Odendahl M, et al. Transfer of minimally manipulated CMV‐specific T cells from stem cell or third‐party donors to treat CMV infection after allo‐HSCT. Leukemia. 2017;31(10):2161‐2171. https://doi.org/10.1038/leu.2017.16.
Pei XY, Zhao XY, Chang YJ, et al. Cytomegalovirus‐specific T‐cell transfer for refractory cytomegalovirus infection after haploidentical stem cell transplantation: the quantitative and qualitative immune recovery for cytomegalovirus. J Infect Dis. 2017;216(8):945‐956. https://doi.org/10.1093/infdis/jix357.
Tzannou I, Papadopoulou A, Watanabe A, et al. Adoptive immunotherapy with rapidly‐generated multivirus‐specific T cells against ADV, EBV, CMV, HHV6 and BK after allogeneic hematopoietic stem cell transplant. Blood. 2017;130:4484.
Tzannou I, Papadopoulou A, Naik S, et al. Off‐the‐shelf virus‐specific T cells to treat BK virus, human herpesvirus 6, cytomegalovirus, Epstein‐Barr virus, and adenovirus infections after allogeneic hematopoietic stem‐cell transplantation. J Clin Oncol. 2017;35(31):3547‐3557. https://doi.org/10.1200/jco.2017.73.0655.
Withers B, Blyth E, Clancy LE, et al. Long‐term control of recurrent or refractory viral infections after allogeneic HSCT with third‐party virus‐specific T cells. Blood Adv. 2017;1(24):2193‐2205. https://doi.org/10.1182/bloodadvances.2017010223.
Kallay K, Kassa C, Reti M, et al. Early experience with CliniMACS prodigy CCS (IFN‐gamma) system in selection of virus‐specific T cells from third‐party donors for pediatric patients with severe viral infections after hematopoietic stem cell transplantation. J Immunother. 2018;41(3):158‐163. https://doi.org/10.1097/cji.0000000000000197.
Ma CKK, Clancy L, Simms R, et al. Adjuvant peptide pulsed dendritic cell vaccination in addition to T cell adoptive immunotherapy for cytomegalovirus infection in allogeneic hematopoietic stem cell transplantation recipients. Biol Blood Marrow Transplant. 2018;24(1):71‐77. https://doi.org/10.1016/j.bbmt.2017.08.028.
Abraham AA, John TD, Keller MD, et al. Safety and feasibility of virus‐specific T cells derived from umbilical cord blood in cord blood transplant recipients. Blood Adv. 2019;3(14):2057‐2068. https://doi.org/10.1182/bloodadvances.2019000201.
Keller MD, Darko S, Lang H, et al. T‐cell receptor sequencing demonstrates persistence of virus‐specific T cells after antiviral immunotherapy. Br J Haematol. 2019;187(2):206‐218. https://doi.org/10.1111/bjh.16053.
Tasnády S, Karászi É, Szederjesi A, et al. Identification of the best‐suited donor for generating virus‐specific T cells. Vox Sang. 2020;115(1):18‐26. https://doi.org/10.1111/vox.12857.
Jiang W, Clancy LE, Avdic S, et al. Third‐party CMV‐ and EBV‐specific T‐cells for first viral reactivation after allogeneic stem cell transplant. Blood Adv. 2022;6(17):4949‐4966. https://doi.org/10.1182/bloodadvances.2022007103.
Pei XY, Zhao XY, Liu XF, et al. Adoptive therapy with cytomegalovirus‐specific T cells for cytomegalovirus infection after haploidentical stem cell transplantation and factors affecting efficacy. Am J Hematol. 2022;97(6):762‐769. https://doi.org/10.1002/ajh.26535.
Wang XD, Yu UE, Yang CL, et al. Cytomegalovirus (CMV)‐specific cytotoxic T lymphocyte therapy resolve CMV diseases and refractory CMV infections in paediatric recipients of allogeneic haematopoietic stem cell transplantation. Bone Marrow Transplant. 2022;57(2):271‐275. https://doi.org/10.1038/s41409‐021‐01499‐0.
Galletta TJ, Lane A, Lutzko C, et al. Third‐party and patient‐specific donor‐derived virus‐specific T cells demonstrate similar efficacy and safety for management of viral infections after hematopoietic stem cell transplantation in children and young adults. Transplant Cell Ther. 2023;29(5):305‐310. https://doi.org/10.1016/j.jtct.2023.01.027.
Heinz AT, Calkoen FGJ, Derbich A, et al. Automated production of specific T cells for treatment of refractory viral infections after allogeneic stem cell transplantation. Haematologica. 2023;108(8):2080‐2090. https://doi.org/10.3324/haematol.2022.281996.
Prockop SE, Hasan A, Doubrovina E, et al. Third‐party cytomegalovirus‐specific T cells improved survival in refractory cytomegalovirus viremia after hematopoietic transplant. J Clin Invest. 2023;133(10). https://doi.org/10.1172/jci165476.
Jakharia N, Howard D, Riedel DJ. CMV infection in hematopoietic stem cell transplantation: prevention and treatment strategies. Curr Treat Options Infect Dis. 2021;13(3):123‐140. https://doi.org/10.1007/s40506‐021‐00253‐w.
Shafat MS, Mehra V, Peggs KS, Roddie C. Cellular therapeutic approaches to cytomegalovirus infection following allogeneic stem cell transplantation. Front Immunol. 2020;11:1694. https://doi.org/10.3389/fimmu.2020.01694.
Czyżewski K, Styczyński J, Giebel S, et al. Age‐dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study. Ann Hematol. 2019;98(9):2197‐2211. https://doi.org/10.1007/s00277‐019‐03755‐2.
Mardani M, Abolghasemi S, Shabani S, et al. The association of conditioning regimen with cytomegalovirus reactivation after allogeneic hematopoietic stem cell transplantation. Iran J Microbiol. 2020;12(6):636‐643. https://doi.org/10.18502/ijm.v12i6.5040.
Bayever E, Champlin R, Ho W, et al. Comparison between bone marrow transplantation and antithymocyte globulin in treatment of young patients with severe aplastic anemia. J Pediatr. 1984;105(6):920‐925. https://doi.org/10.1016/s0022‐3476(84)80078‐5.
Micklethwaite KP, Clancy L, Sandher U, et al. Prophylactic infusion of cytomegalovirus‐specific cytotoxic T lymphocytes stimulated with Ad5f35pp65 gene‐modified dendritic cells after allogeneic hemopoietic stem cell transplantation. Blood. 2008;112(10):3974‐3981. https://doi.org/10.1182/blood‐2008‐06‐161695.
Chemaly RF, Ullmann AJ, Stoelben S, et al. Letermovir for cytomegalovirus prophylaxis in hematopoietic‐cell transplantation. N Engl J Med. 2014;370(19):1781‐1789. https://doi.org/10.1056/nejmoa1309533.
Boeckh M, Ljungman P. How we treat cytomegalovirus in hematopoietic cell transplant recipients. Blood. 2009;113(23):5711‐5719. https://doi.org/10.1182/blood‐2008‐10‐143560.

Keywords: adoptive T‐cell therapy; cytomegalovirus; meta‐analysis

Date Created: 20240615 Date Completed: 20240615 Latest Revision: 20240615

20240616

10.1002/rmv.2558

38878003