{"doi":"10.1093/cid/ciab1064","title":"Impact of Letermovir Primary Cytomegalovirus Prophylaxis on 1-Year Mortality After Allogeneic Hematopoietic Cell Transplantation: A Retrospective Cohort Study","abstract":"BACKGROUND: Cytomegalovirus (CMV)-seropositive (R+) hematopoietic cell transplant (HCT) recipients have a survival disparity compared with CMV-seronegative recipient/donor (R-D-) pairs. We hypothesized that primary letermovir prophylaxis (LET) may abrogate this disparity. We investigated the relationship between LET and mortality at 1 year post-HCT. METHODS: In this retrospective cohort study, we included adult R-D- or R+ patients who received HCT pre-LET (between 1 January 2013 through 15 December 2017) and post-LET (between 16 December 2017 through December 2019). R+ were categorized by LET receipt as R+/LET or R+/no-LET. Cox proportional hazard models were used to estimate the association of LET with all-cause mortality at 1 year after transplantation. RESULTS: Of 848 patients analyzed, 305 were R-D-, 364 R+/no-LET, and 160 R+/LET. Because of similar mortality (adjusted hazard ratio [aHR], 1.29 [95% confidence interval {CI}, .76-2.18]; P = .353]) between pre-LET/R-D- and post-LET/R-D-, R-D- were combined into 1 group. Compared with R-D-, the aHR for mortality was 1.40 (95% CI, 1.01-1.93) for R+/no-LET and 0.89 (95% CI, .57-1.41) for R+/LET. Among R+, LET was associated with decreased risk of death (aHR, 0.62 [95% CI, .40-.98]); when conventional HCT and T-cell depleted HCT were analyzed separately, the aHR was 0.86 (95% CI, .51-1.43) and 0.21 (95% CI, .07-.65), respectively. CONCLUSIONS: At 1 year post-HCT, LET was associated with closing the mortality disparity between R-D- and R+. Among all R+, LET was associated with decreased mortality, driven by 79% reduced incidence of death in T-cell depleted HCT.","journal":"Clinical Infectious Diseases","year":2022,"id":240613,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":44,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9578,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":317420,"name":"Anat Stern","orcid":"0000-0002-8659-8108","position":1,"is_corresponding":false},{"id":868644,"name":"Eleni Karantoni","orcid":"0000-0002-6129-4730","position":2,"is_corresponding":false},{"id":868645,"name":"Tamara Nawar","orcid":"0000-0001-7164-2746","position":3,"is_corresponding":false},{"id":869270,"name":"Gyuri Han","orcid":null,"position":4,"is_corresponding":false},{"id":317418,"name":"Phaedon D. Zavras","orcid":"0000-0001-7888-385X","position":5,"is_corresponding":false},{"id":718793,"name":"Henry Dumke","orcid":null,"position":6,"is_corresponding":false},{"id":108866,"name":"Christina Cho","orcid":"0000-0002-7964-3011","position":7,"is_corresponding":false},{"id":268584,"name":"Roni Tamari","orcid":"0000-0002-2386-0850","position":8,"is_corresponding":false},{"id":352732,"name":"Brian C. Shaffer","orcid":"0000-0003-3433-9179","position":9,"is_corresponding":false},{"id":108874,"name":"Sergio Giralt","orcid":"0000-0003-1944-5053","position":10,"is_corresponding":false},{"id":352731,"name":"Ann A. Jakubowski","orcid":"0000-0003-1955-513X","position":11,"is_corresponding":false},{"id":108873,"name":"Miguel‐Angel Perales","orcid":"0000-0002-5910-4571","position":12,"is_corresponding":false},{"id":228381,"name":"Genovefa A. Papanicolaou","orcid":"0000-0002-2891-079X","position":13,"is_corresponding":false},{"id":317419,"name":"Yiqi Su","orcid":"0000-0003-1042-3878","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-19T00:22:51.435773Z","pmid":"34979021","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}