@article{Malagola_Greco_Santarone_Iori_Quatrocchi_Barberi_Antonella_Leotta_Carotti_Pierini_et al._2019, title={CMV MANAGEMENT WITH SPECIFIC IMMUNOGLOBULINS: A MULTICENTRIC RETROSPECTIVE ANALYSIS ON 92 ALLOTRANSPLANTED PATIENTS.: Anti-CMV immunoglobulins for CMV treatment}, volume={11}, url={https://www.mjhid.org/mjhid/article/view/2019.048}, DOI={10.4084/mjhid.2019.048}, abstractNote={<p align="justify" class="western" style="line-height: 150%; margin-bottom: 0cm;"><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;">CMV represent</span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span lang="en-US"><span style="text-decoration: none;">s</span></span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;"> one of the most serious life-threatening complications of allogeneic stem cell transplantaion (allo-SCT). Pre-emptive treatment is hig</span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span lang="en-US"><span style="text-decoration: none;">h</span></span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;">ly effective, but toxicity and repetitive reactivation of CMV represent a major challenge in </span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span lang="en-US"><span style="text-decoration: none;">the </span></span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;">clinical practice. The use of anti-CMV specific immunoglobulins (Megalotect) is controversial.</span></span></span></span></p> <p align="justify" class="western" style="line-height: 150%; margin-bottom: 0cm;"><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;"> We retrospectively collected data on 92 patients submitted to allo-SCT for hematological malignancies, in whom Megalotect was used either for prophylaxis (n=14) or with pre-emptive therapy (n=78). All the patients were considered at high-risk of developing CMV reactivation and CMV disease.</span></span></span></span></p> <p align="justify" class="western" style="line-height: 150%; margin-bottom: 0cm;"><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;"> The treatment was well tolerated, with </span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span lang="en-US"><span style="text-decoration: none;">no</span></span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;"> reported infusion reactions</span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span lang="en-US"><span style="text-decoration: none;">,</span></span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;"> nor other adverse events. None of the 14 cases treated with Megalotect as prophylaxis developed CMV reactivation. 51/78 (65%) patients who received Megalotect during pre-emptive treatment achieved </span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span lang="en-US"><span style="text-decoration: none;">complete clearance of CMV viremia, and 14/51 patients (29%) developed a breakthroug CMV infection. 7/78 patients (9%) developed CMV disease.</span></span></span></span></span> <span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span lang="en-US"><span style="text-decoration: none;">The projected 1-year OS, 1-year TRM and 1-year RR is 74%, 15% and 19%, respectively. No differences were observed in terms of OS, TRM and RR by comparing patients who achieved a complete response after treatment versus those who did not..</span></span></span></span></span></p> <p align="justify" class="western" style="line-height: 150%; margin-bottom: 0cm;"><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span lang="en-US"><span style="text-decoration: none;"> These</span></span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;"> retrospective data suggest</span></span></span></span> <span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;">that Megalotect is safe and well tolerated. </span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span lang="en-US"><span style="text-decoration: none;">When used as prophylaxis, no CMV reactivation was recorded.</span></span></span></span></span><span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;"> We have no conclusive data regarding its efficacy in reducing the cumulative dose of anti-CMV specific drugs in the pre-emptive setting.</span></span></span></span> <span style="color: rgb(0, 0, 128);"><span lang="zxx"><span style="color: rgb(0, 0, 0);"><span style="text-decoration: none;">Further prospective trials are warrented to identify the best setting of patients who can benefit from Megalotect alone or in addition to anti-CMV specific drugs. </span></span></span></span></p>}, number={1}, journal={Mediterranean Journal of Hematology and Infectious Diseases}, author={Malagola, Michele and Greco, Raffaella and Santarone, Stella and Iori, Anna Paola and Quatrocchi, Luisa and Barberi, Walter and Antonella, Bruzzese and Leotta, Salvatore and Carotti, Alessandra and Pierini, Antonio and et al.}, year={2019}, month={Aug.}, pages={e2019048} }