Combined Therapy with Intravenous Immunoglobulins, Letermovir and (Val-)Ganciclovir in Complicated Courses of CMV-Infection in Transplant Recipients

Veronica Di Cristanziano; Patrick Affeldt; Moritz Trappe; Maike Wirtz; Eva Heger; Elena Knops; Rolf Kaiser; Dirk Stippel; Roman-Ulrich Müller; Udo Holtick; Christoph Scheid; Martin Kann; Christine E Kurschat; Franziska Grundmann

doi:10.3390/microorganisms9081666

Combined Therapy with Intravenous Immunoglobulins, Letermovir and (Val-)Ganciclovir in Complicated Courses of CMV-Infection in Transplant Recipients

Microorganisms. 2021 Aug 4;9(8):1666. doi: 10.3390/microorganisms9081666.

Authors

Affiliations

¹ Institute of Virology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Fürst-Pückler Straße 56, 50935 Cologne, Germany.
² Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany.
³ Department of General, Visceral, Cancer and Transplant Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany.
⁴ CECAD, Faculty of Medicine, University Hospital Cologne, University of Cologne, Joseph-Stelzmann Straße 26, 50931 Cologne, Germany.
⁵ Department I of Internal Medicine, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany.

Abstract

The treatment options for cytomegalovirus (CMV) infections in immunosuppressed patients are limited, mainly consisting of (val-)ganciclovir (VGC/GCV) as the first-line treatment. We report on three transplant recipients, one stem cell transplant (allo-HSCT) patient and two kidney transplant (KTx) recipients, with prolonged CMV viremia treated with a combined therapy based on letermovir (LMV), CMV-specific intravenous immunoglobulins (IVIg), and VGC/GCV, which led to the sustained control of CMV viremia in all patients.

Keywords: CMV; ELISPOT; bone marrow; cellular response; combination; drug resistance; immunosuppression; kidney; opportunistic infection; transplantation.

Publication types

Case Reports