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Cytomegalovirus Diseases in Hematopoietic Cell Transplant Recipients

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Pulmonary and Critical Care Considerations of Hematopoietic Stem Cell Transplantation

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Abstract

Cytomegalovirus (CMV) infection is one of the most significant posttransplant complications among hematopoietic cell transplant (HCT) recipients. As such, clinical providers are frequently faced with challenging clinical scenarios that may impact treatment and management decisions. These challenges are often amplified in the critical care setting, as CMV can lead to severe single or multi-organ disease and increase posttransplant non-relapse mortality and overall mortality. Additionally, CMV has been associated with secondary invasive fungal and bacterial infections, attributed to modulations of the host immune system. Complications may arise during the management of CMV infection and/or disease due to serious toxicities from the most available anti-CMV agents. The recent approval of two anti-CMV drugs, letermovir for CMV prophylaxis and maribavir for the treatment of resistant and/or refractory CMV, has significantly improved the CMV landscape in these transplant recipients. This chapter provides an overview of CMV infections including pathophysiology, risk factors, preventative strategies for HCT recipients, and treatment of resistant or refractory CMV infections.

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  1. Department of Infectious Diseases, Infection Control and Employee Health, Unit 1460, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Alexander Franklin, Amy Spallone & Roy F. Chemaly

  2. Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA

    Alexander Franklin

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    Ayman O. Soubani

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Franklin, A., Spallone, A., Chemaly, R.F. (2023). Cytomegalovirus Diseases in Hematopoietic Cell Transplant Recipients. In: Soubani, A.O. (eds) Pulmonary and Critical Care Considerations of Hematopoietic Stem Cell Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-031-28797-8_10

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