{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:13:49Z","timestamp":1789143229965,"version":"build-2803163510"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The control of cytomegalovirus (CMV) reactivation after allogeneic hematopoietic stem cell transplantation (allo-HSCT) depends heavily on the reconstitution of CMV-specific cell-mediated immunity (CMV-CMI). This study aimed to assess whether CMV-CMI\u2013guided letermovir prophylaxis is more effective than a fixed-duration approach in reducing the incidence of late-onset clinically significant CMV infection (cs-CMVi).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 182 adults who underwent allo-HSCT at 4 participating hospitals. Individuals who received transplantation between June 2022 and April 2023 were treated with a fixed 100-day course of letermovir (fixed-duration group, n = 78), while those receiving transplantation from February 2023 to February 2024 received letermovir based on their CMV-CMI status (CMV-CMI\u2013guided group, n = 104).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 1-year cumulative incidence of late-onset cs-CMVi was significantly lower in the CMV-CMI\u2013guided group compared with the fixed-duration group (9.7% vs 24.8%, P = .019). The CMV-CMI\u2013guided group also had improved overall survival (89.1% vs 77.1%, P = .04) and relapse-free survival (88.4% vs 76.8%, P = .01). Patients were divided into high-risk (n = 36) and low-risk (n = 146) groups, based on risk factors for late-onset cs-CMVi. Among high-risk individuals, the cumulative incidence of late-onset cs-CMVi was significantly lower in the CMV-CMI\u2013guided group than in the fixed-duration group (12.5% vs 46.3%, P = .04).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CMV-CMI\u2013guided letermovir prophylaxis may help reduce the risk of late-onset cs-CMVi, particularly in individuals at high risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>NCT06708130.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf410","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T11:45:43Z","timestamp":1753357543000},"page":"597-606","source":"Crossref","is-referenced-by-count":13,"title":["Letermovir Prophylaxis Guided by Cytomegalovirus Cell-Mediated Immunity Improves the Outcomes of Allogeneic Hematopoietic Stem Cell Transplant Recipients"],"prefix":"10.1093","volume":"82","author":[{"given":"Luxiang","family":"Wang","sequence":"first","affiliation":[{"name":"Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingtao","family":"Huang","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanhe","family":"Jiang","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meijuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojia","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Hematology, Lanzhou University Second Hospital , Lanzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shanghai Liquan Hospital , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zilu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayu","family":"Huang","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyang","family":"Lu","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zengkai","family":"Pan","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shanghai Zhaxin Hospital , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Health Statistics, Naval Medical University , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"He","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]},{"name":"Nursing Department, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0152-639X","authenticated-orcid":false,"given":"Yang","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of 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