{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:11:52Z","timestamp":1789031512662,"version":"build-2803163510"},"reference-count":68,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"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":["Internal Medicine Journal"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Despite pre\u2010emptive treatment (PeT), cytomegalovirus (CMV) disease and reactivation remain a clinical concern. In Australia and New Zealand (ANZ), variability exists in the management of CMV for haematopoietic stem cell transplantation (HSCT) recipients.<\/jats:p>\n <\/jats:sec>\n \n Aims and Methods<\/jats:title>\n To understand the state of practice in Australia, a survey captured insights on detection, monitoring, prophylaxis and treatment from 21 sites, including 11 chimeric antigen receptor T\u2010cell (CAR\u2010T) therapy sites.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Respondents reported 26 cases of CMV disease after HSCT and four cases after CAR\u2010T in 2024. All HSCT sites and four CAR\u2010T sites had CMV protocols. Commonly, CMV nucleic acid viral load (VL) testing was employed weekly. Sites utilised plasma (66%) or whole blood (33%). VL was reported as IU\/mL (66%), copies\/mL (29%) or not specified (5%). One third of respondents tested CMV DNAemia before HSCT. All recipients were monitored regardless of CMV serostatus. Half the sites employed post\u2010HSCT CMV prophylaxis using letermovir (nine sites), (val)aciclovir (eight) and (val)ganciclovir (three). VL thresholds for PeT ranged from 100 to 5000 IU\/mL. Most sites used (val)ganciclovir for PeT, with foscarnet second line. At 76% of HSCT sites, PeT continued until two consecutive negative results. Frontline therapy for CMV disease is ganciclovir; 86% of ANZ sites used (val)ganciclovir while three paediatric sites used foscarnet. For resistant or refractory CMV, guidelines recommend foscarnet or maribavir, although maribavir was not funded or used during the survey period. CMV\u2010specific immunotherapy can be considered.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Institutional preferences and medicine funding drives variability in ANZ practice. This leaves potential for healthcare inequity since newer antiviral agents are inconsistently used, contrasting with international guidelines.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/imj.70627","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:05:28Z","timestamp":1789031128000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["ANZTCT<\/scp>\n cytomegalovirus practice survey for allogeneic haemopoietic stem cell transplant and cellular therapy recipients in Australia and New Zealand"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2261-169X","authenticated-orcid":false,"given":"Andrea","family":"Henden","sequence":"first","affiliation":[{"name":"Cancer Care Services Royal Brisbane and Women's Hospital Brisbane Queensland Australia"},{"name":"Faculty of Health, Medicine and Behavioural Sciences University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4250-4448","authenticated-orcid":false,"given":"Lynette","family":"Chee","sequence":"additional","affiliation":[{"name":"Department of Clinical Haematology The Royal Melbourne Hospital and Peter MacCallum Cancer Centre Melbourne Victoria Australia"},{"name":"Department of Medicine University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7746-0599","authenticated-orcid":false,"given":"Julia","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Queensland Children's Hospital Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2344-1365","authenticated-orcid":false,"given":"Rachel","family":"Conyers","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4820-6406","authenticated-orcid":false,"given":"Julian","family":"Cooney","sequence":"additional","affiliation":[{"name":"Department of Haematology Fiona Stanley Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Doocey","sequence":"additional","affiliation":[{"name":"Clinical Haematology Department Auckland Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5807-1766","authenticated-orcid":false,"given":"David","family":"Gottlieb","sequence":"additional","affiliation":[{"name":"Blood Transplant and Cell Therapies Program Westmead Hospital Sydney New South Wales Australia"},{"name":"Westmead T\u2010Cell Therapies Group Westmead Institute for Medical Research Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4078-5001","authenticated-orcid":false,"given":"Tim","family":"Prestidge","sequence":"additional","affiliation":[{"name":"Blood and Cancer Centre Starship Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2458-3111","authenticated-orcid":false,"given":"Madeleine","family":"Powys","sequence":"additional","affiliation":[{"name":"Haematology Department Westmead Children's Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5647-4673","authenticated-orcid":false,"given":"Philip","family":"Selby","sequence":"additional","affiliation":[{"name":"Haematology Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"Pharmacometrics, School of Pharmacy and Biomedical Sciences Adelaide University Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5566-2488","authenticated-orcid":false,"given":"Gaurav","family":"Sutrave","sequence":"additional","affiliation":[{"name":"Blood Transplant and Cell Therapies Program Westmead Hospital Sydney New South Wales Australia"},{"name":"Westmead T\u2010Cell Therapies Group Westmead Institute for Medical Research Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4438-5817","authenticated-orcid":false,"given":"Eric","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne Melbourne Victoria Australia"},{"name":"Department of Clinical Haematology Austin Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8692-4145","authenticated-orcid":false,"given":"Michelle K.","family":"Yong","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne Melbourne Victoria Australia"},{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre and Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7929-1450","authenticated-orcid":false,"given":"Nada","family":"Hamad","sequence":"additional","affiliation":[{"name":"Department of Haematology St Vincent's Hospital Sydney Sydney New South Wales Australia"},{"name":"School of Clinical Medicine, Faculty of Medicine and Health UNSW Sydney Sydney New South Wales Australia"},{"name":"School of Medicine University of Notre Dame Sydney New South Wales 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T\u2010cell\u2010engaging therapies","volume":"25","author":"Ljungman P","year":"2025","journal-title":"Lancet Infect Dis"},{"key":"e_1_2_8_12_1","unstructured":"AveryRK AlainS AlexanderBD BlumbergEA ChemalyRF CordonnierCet al.Maribavir for refractory cytomegalovirus infections with or without resistance post\u2010transplant: results from a phase 3 randomized clinical trial clinical infectious diseases.2021;75:690\u2013701."},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","DOI":"10.1111\/tid.13994","article-title":"Effective CMV prophylaxis with high\u2010dose valaciclovir in allogeneic hematopoietic stem\u2010cell recipients at a high risk of CMV infection","volume":"25","author":"Douglas G","year":"2023","journal-title":"Transpl Infect Dis"},{"key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"e127","DOI":"10.1016\/S2352-3026(23)00344-7","article-title":"Efficacy and safety of extended duration letermovir prophylaxis in recipients of haematopoietic stem\u2010cell 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