{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T01:58:23Z","timestamp":1792979903912,"version":"4.5.0"},"reference-count":14,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Cytomegalovirus (CMV) is a common opportunistic infection post\u2010solid organ transplant; however, traditional prophylaxis agents have been associated with myelosuppression, limiting their use. Letermovir (LTV) is an antiviral approved for use in kidney transplantation, and often used off\u2010label in non\u2010renal transplant patients; however, little data exist on cell count recovery and time to recovery in the non\u2010renal and multi\u2010organ transplant population.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a single\u2010center, retrospective, descriptive cohort study at a large academic medical center assessing conversion to LTV from (val)ganciclovir for primary CMV prophylaxis. Outcomes included change in white blood cell (WBC) count from immediately prior to LTV conversion to 30 days post\u2010initiation, indications for switching to LTV, and rates of breakthrough CMV infection.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Fifty\u2010eight patients transplanted between January 1, 2017, and December 31, 2023, were included in this cohort, with the majority being lung transplant recipients (57%). Median increase in WBC was +\u00a02.07\u00a0k\/\u00b5L (IQR 3.95\u20138.21;\n p<\/jats:italic>\n \u00a0<\u00a00.01) from time of LTV initiation to 30 days following conversion. The most common indication for LTV was pancytopenia in 26 patients (45%). Breakthrough CMV infections occurred in four patients (7%), all of which were viremia, and did not exhibit resistance against CMV active agents. There was an observed increase in mycophenolate use and tolerance and a decrease in granulocyte\u2010colony stimulating factor (G\u2010CSF) over the study period.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n LTV was effective and well\u2010tolerated for primary CMV prophylaxis in an extra\u2010renal transplant population and may be a safe alternative in patients experiencing sustained hematologic toxicities with (val)ganciclovir across all transplant groups.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ctr.70366","type":"journal-article","created":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T10:43:23Z","timestamp":1761389003000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Letermovir Conversion for Cytomegalovirus Prophylaxis in Solid Organ Transplant"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8586-5211","authenticated-orcid":false,"given":"Suneri J.","family":"Amin","sequence":"first","affiliation":[{"name":"Department of Pharmacy Houston Methodist Hospital Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex W.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Houston Methodist Hospital Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison N.","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Houston Methodist Hospital Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Nigo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Houston Methodist Hospital Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Mark","family":"Ghobrial","sequence":"additional","affiliation":[{"name":"Department of Surgery Houston Methodist Hospital Houston Texas USA"},{"name":"J.C. Walter Jr. Center for Transplantation Houston Methodist Hospital Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Osama","family":"Gaber","sequence":"additional","affiliation":[{"name":"Department of Surgery Houston Methodist Hospital Houston Texas USA"},{"name":"J.C. Walter Jr. Center for Transplantation Houston Methodist Hospital Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002191"},{"key":"e_1_2_9_3_1","unstructured":"Premyvis [package insert].Merck & Co. Inc.;2017."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1706640"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.9106"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13515"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.14279"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14808"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/transplantology2020013"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10238\u2010024\u201001330\u20102"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000005374"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.15142"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.14337"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.70033"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.70169"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70366","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.70366","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70366","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T20:39:28Z","timestamp":1785443968000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,25]]},"references-count":14,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/ctr.70366"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70366","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,25]]},"assertion":[{"value":"2025-06-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70366"}}