부산대학교 도서관

Angela Chiereghin,1,2 Tamara Belotti,3 Eva Caterina Borgatti,4 Nicola Fraccascia,5 Giulia Piccirilli,6 Maura Fois,3 Michele Borghi,4 Gabriele Turello,4 Liliana Gabrielli,6 Riccardo Masetti,3 Arcangelo Prete,3 Stefano Fanti,5 Tiziana Lazzarotto4 1Section of Microbiology, Department of Specialized, Experimental, and Diagnostic Medicine, University of Bologna, Bologna, Italy; 2Department of Public Health, Local Health Authority of Bologna, Bologna, Italy; 3Pediatric Oncology and Haematology Unit “Lalla Seragnoli”, Department of Pediatrics, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy; 4Microbiology Unit, Department of Specialized, Experimental, and Diagnostic Medicine, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy; 5Nuclear Medicine Unit, Department of Specialized, Experimental, and Diagnostic Medicine, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, Italy; 6Microbiology Unit, IRCCS St. Orsola Polyclinic, University of Bologna, Bologna, ItalyCorrespondence: Tiziana LazzarottoMicrobiology Unit, Department of Specialized, Experimental, and Diagnostic Medicine, IRCCS St. Orsola Polyclinic, University of Bologna, via Massarenti 9, Bologna, 40138, ItalyTel +39 0512143360Fax +39 0512143514Email tiziana.lazzarotto@unibo.itAbstract: Despite the effectiveness of the currently available antiviral drugs in treating cytomegalovirus (CMV) infection, high rates of adverse effects are associated with their use. Moreover, a problem of increasing importance is the emergence of drug-resistant CMV infection. Here, we describe the first case of off-label use of letermovir (LMV) as preemptive antiviral therapy, in a pediatric allogeneic peripheral blood stem cell transplant recipient with ganciclovir-resistant CMV infection who was intolerant to foscarnet and unable to achieve viral clearance after seven doses of cidofovir. After the administration of LMV, a gradual reduction in viral load was observed and within 6 weeks of LMV treatment, after more than 6 months of positive CMV-DNAemia, the patient cleared the infection. No adverse effects associated with LMV were observed during treatment. In this pediatric study case, the off-label use of LMV for the treatment of CMV infection has been well tolerated and proved to be effective in leading to the suppression of viral replication.Keywords: pediatric allogeneic peripheral blood stem cell transplant, GCV-resistant CMV, intolerance to FOS, off-label letermovir use