{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:57:00Z","timestamp":1778155020520,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T00:00:00Z","timestamp":1535673600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Currently, there are no prospective, randomized trials analyzing leflunomide for the treatment of cytomegalovirus infection or disease in allogeneic stem cell transplant patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The primary objective of this case series was to determine the clinical and virological responses of utilizing leflunomide as therapy for refractory cytomegalovirus infections, unresponsive to first-line therapy in allogeneic stem cell transplant patients. Additionally, patient and leflunomide specific characteristics were identified and determined in this descriptive case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a single-center, case series of adult allogeneic stem cell transplant patients with refractory cytomegalovirus infections receiving leflunomide between 1 January 2005 and 31 March 2015.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 14 patients with refractory cytomegalovirus infections received leflunomide. All patients received concurrent anti-cytomegalovirus therapy. Nine of 13 patients tested positive for phosphotransferase UL97 and\/or viral DNA polymerase UL54 genotype mutations. Nine patients achieved a virological response with undetectable cytomegalovirus titers. Of the 13 patients with teriflunomide serum levels, eight patients maintained levels &gt;40 micrograms\/milliliter (mcg\/mL). Common adverse effects were pancytopenia (n\u2009=\u20098) and elevated liver function tests (n\u2009=\u20094).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite current strategies, refractory or recurrent cytomegalovirus infection and disease remain a clinical challenge to treat in the stem cell transplant patient population. Leflunomide used in combination with other concomitant therapies use for refractory cytomegalovirus infection in clinical practice may be a safe and effective option in the allogeneic stem cell transplant patient population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1078155218796188","type":"journal-article","created":{"date-parts":[[2018,9,1]],"date-time":"2018-09-01T01:11:28Z","timestamp":1535764288000},"page":"1731-1737","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Leflunomide therapy for refractory cytomegalovirus infections in hematopoietic stem cell transplant recipients"],"prefix":"10.1177","volume":"25","author":[{"given":"Emily","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna S","family":"Jan","sequence":"additional","affiliation":[{"name":"Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vi P","family":"Doan","sequence":"additional","affiliation":[{"name":"Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill B","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7422-8951","authenticated-orcid":false,"given":"Jason C","family":"Yeh","sequence":"additional","affiliation":[{"name":"Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,8,31]]},"reference":[{"key":"bibr1-1078155218796188","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-10-143560"},{"key":"bibr2-1078155218796188","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2013.09.004"},{"key":"bibr3-1078155218796188","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw668"},{"key":"bibr4-1078155218796188","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2014.11.002"},{"key":"bibr5-1078155218796188","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181e94106"},{"key":"bibr6-1078155218796188","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704694"},{"key":"bibr7-1078155218796188","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2011.00682.x"},{"key":"bibr8-1078155218796188","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2016.08.027"},{"key":"bibr9-1078155218796188","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200503173521125"}],"container-title":["Journal of Oncology Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078155218796188","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1078155218796188","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078155218796188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:19:43Z","timestamp":1777688383000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1078155218796188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,31]]},"references-count":9,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1177\/1078155218796188"],"URL":"https:\/\/doi.org\/10.1177\/1078155218796188","relation":{},"ISSN":["1078-1552","1477-092X"],"issn-type":[{"value":"1078-1552","type":"print"},{"value":"1477-092X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,31]]}}}