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We conducted a retrospective study to determine the clinical and economic burden of pre\u2010emptive therapy (PET) for CMV infection in 100 consecutive hospitalized adult CMV positive serostatus allo\u2010HCT recipients and compared their hospitalization cost with allo\u2010HCT recipients hospitalized with graft vs host disease without CMV infection (control group) and across 19 US cancer centers for hospitalized patients with CMV infection between 2012 and 2015 (Vizient database). A total of 192 CMV episodes of PET for CMV infection occurred within 1 year post\u2010HCT. PET consisted of ganciclovir (41% of episodes), foscarnet (40%), and valganciclovir (38%) with the longest average length of stay in foscarnet\u2010treated patients (41 days). The average direct cost per patient admitted for PET was $116\u2009976 (range: $7866\u2010$641\u2009841) compared with $12\u2009496 (range: $2004\u2010$43\u2009069) in the control group (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001). The total direct cost per encounter was significantly higher in patients treated with foscarnet and had nephrotoxicity ($284\u2009006) compared with those who did not ($112\u2009195). The average cost amongst the 19 US cancer centers, including our institution, was $42\u2009327 with major disparities in cost and clinical outcomes. PET for CMV infection is associated with high economic burden in allo\u2010HCT recipients.<\/jats:p>","DOI":"10.1002\/jmv.25574","type":"journal-article","created":{"date-parts":[[2019,8,26]],"date-time":"2019-08-26T09:44:49Z","timestamp":1566812689000},"page":"86-95","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Clinical and economic burden of pre\u2010emptive therapy of cytomegalovirus infection in hospitalized allogeneic hematopoietic cell transplant recipients"],"prefix":"10.1002","volume":"92","author":[{"given":"Lynn","family":"El Haddad","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Infection Control and Employee Health The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shashank S.","family":"Ghantoji","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Infection 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