{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:07:18Z","timestamp":1788448038347,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Letermovir has been approved as a novel cytomegalovirus (CMV) prophylactic agent after allogeneic hematopoietic stem cell transplantation (HSCT). However, there are still insufficient data to properly evaluate the real\u2010world role of letermovir, and the risk factors for CMV reactivation under letermovir prophylaxis have not been clarified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a single\u2010institution retrospective analysis of patients under prophylaxis with or without letermovir who underwent allogeneic HSCT between March 2012 and December 2019. In August 2018, letermovir was added to the clinical practice at our institution for the prophylaxis of CMV reactivation in allogeneic HSCT recipients. Patients who underwent HSCT without prophylactic letermovir from March 2012 until September 2018 served as a historical control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cumulative incidence of clinically significant CMV infection (CS\u2010CMVi) was significantly lower in the letermovir group than in the historical control group not receiving letermovir (30.2%\u00a0vs. 71.6%, <jats:italic>p<\/jats:italic> &lt; .05, at 100 days). In addition, the cumulative incidence of non\u2010relapse mortality (NRM) at day 500 was significantly lower in the letermovir group (4.7%\u00a0vs. 19.8%, <jats:italic>p<\/jats:italic> &lt; .05). We then performed a risk factor analysis for developing CS\u2010CMVi in the letermovir group. The only significant factor identified by this multivariable analysis was transplantation from a CMV seronegative donor to a seropositive recipient (Hazard ratio = 2.76, 95% confidence interval 1.14\u20136.68, <jats:italic>p<\/jats:italic> &lt; .05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study showed that letermovir prophylaxis significantly reduced the incidence of CS\u2010CMVi and NRM in a real\u2010world setting and that the CMV serostatus of the donor remained as a risk factor for CS\u2010CMVi even under letermovir prophylaxis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13904","type":"journal-article","created":{"date-parts":[[2022,7,23]],"date-time":"2022-07-23T16:41:25Z","timestamp":1658594485000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Risk factor analysis for cytomegalovirus reactivation under prophylaxis with letermovir after allogeneic hematopoietic stem cell transplantation"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6090-0260","authenticated-orcid":false,"given":"Kota","family":"Mizuno","sequence":"first","affiliation":[{"name":"Division of Hematology Department of Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Kato","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryohei","family":"Abe","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Koda","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiko","family":"Mori","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Medicine Keio University School of Medicine  Tokyo Japan"},{"name":"Department of Hematology Tokyo Medical 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