Recommendations from the 10th European Conference on Infections in Leukaemia for the management of cytomegalovirus in patients after allogeneic haematopoietic cell transplantation and other T-cell-engaging therapies

Abstract

Cytomegalovirus (CMV) remains the most important viral pathogen in patients after allogeneic haematopoietic cell transplantation (HCT), resulting in morbidity and mortality. The European Conference on Infections in Leukaemia (ECIL) brings together experts in several fields to produce evidence-based recommendations from comprehensive literature reviews. Management of CMV has been addressed twice before; the previous guideline update from the ECIL was published in 2019. The 10th ECIL meeting in 2024 addressed new developments in CMV management after allogeneic HCT, and recommendations are presented in this Review. Management recommendations include diagnostics, such as immune monitoring, antiviral prophylaxis with letermovir, management of resistant and refractory CMV infections, and paediatric aspects of CMV management. Furthermore, the 10th ECIL introduced recommendations for two new categories: patients treated with chimeric antigen receptor T cells or treated with bispecific T-cell-engaging antibodies.