Eosinophilia during letermovir treatment after allogeneic hematopoietic stem cell transplantation
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LETTER TO THE EDITOR
Eosinophilia during letermovir treatment after allogeneic hematopoietic stem cell transplantation Hiroki Hosoi 1
&
Shogo Murata 1 & Toshiki Mushino 1 & Akinori Nishikawa 1 & Takashi Sonoki 1
Received: 29 July 2020 / Accepted: 16 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Dear Editor, Eosinophilia can be caused by various conditions, such as allergies and hematological malignancies. Eosinophilia also occurs after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the conditions that cause eosinophilia after allo-HSCT remain unclear. Although drug allergies can cause eosinophilia, few studies have examined which drugs tend to induce eosinophilia after allo-HSCT. Recently, new drugs, such as letermovir, have been used to prevent infections after allo-HSCT. Letermovir has a novel mechanism of action and is widely used to prevent human cytomegalovirus replication after HSCT [1]. Here, we examine the occurrence of eosinophilia during the administration of letermovir after alloHSCT. At our hospital, letermovir has been administered to transplant recipients to prevent cytomegalovirus (CMV) reactivation since October 2018. In this study, 22 patients who underwent allo-HSCT after September 2018 and were treated with letermovir (letermovir group) were compared with 22 patients who were not treated with letermovir (non-letermovir group). The details of the case selection process are shown in Supplementary Fig. 1. The unpaired t test was used to determine the significance of intergroup differences in eosinophil counts. The cumulative incidence of grade II–IV acute graftversus-host disease (aGVHD) was estimated, where death without grade II–IV acute GVHD was considered a competing risk. P values of < 0.05 were considered statistically significant. All statistical analyses were performed using GraphPad Prism 8 (GraphPad Software Inc., San Diego, Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00277-020-04226-9) contains supplementary material, which is available to authorized users. * Hiroki Hosoi [email protected] 1
Department of Hematology/Oncology, Wakayama Medical University, Kimiidera 811-1, Wakayama 641-8510, Japan
CA, USA) or EZR (Saitama Medical Center, Saitama, Japan) [2]. The characteristics of the subjects in each group are described in Supplementary Tables S1 and S2. There were no significant differences in disease risk or conditioning regimen between the letermovir and non-letermovir groups. In a phase 3 trial examining the efficacy of letermovir, the incidence of eosinophilia did not differ significantly between the letermovir and placebo groups [3]. In the latter study, most patients underwent peripheral blood stem cell transplantation (PBSCT). Therefore, in our study, the maximum eosinophil count was analyzed according to whether the patients underwent PBSCT or non-PBSCT. Among the patients who underwent non-PBSCT, the mean maximum eosinophil count within 3 months after the allo-H
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