Patient demographics
| Categories . | Letermovir era∗ (n = 327) . | Preemptive therapy era (n = 1367) . | Combined (N = 1694) . |
|---|---|---|---|
| Age at transplant, y | |||
| 0-11 | 0 (0%) | 144 (11%) | 144 (9%) |
| 12-17 | 0 (0%) | 76 (6%) | 76 (4%) |
| 18+ | 327 (100%) | 1147 (84%) | 1474 (87%) |
| Race | |||
| White | 242 (74%) | 1043 (76%) | 1285 (76%) |
| American Indian or Alaska Native | 4 (1%) | 29 (2%) | 33 (2%) |
| Asian | 37 (11%) | 141 (10%) | 178 (11%) |
| Black or African American | 9 (3%) | 40 (3%) | 49 (3%) |
| Multiple | 7 (2%) | 36 (3%) | 43 (3%) |
| Native Hawaiian or other Pacific Islander | 7 (2%) | 25 (2%) | 32 (2%) |
| Unknown | 21 (6%) | 53 (4%) | 74 (4%) |
| Ethnicity | |||
| Hispanic or Latino | 34 (10%) | 130 (10%) | 164 (10%) |
| Not Hispanic or Latino | 274 (84%) | 1194 (87%) | 1468 (87%) |
| Unknown | 19 (6%) | 43 (3%) | 62 (4%) |
| Sex | |||
| Female | 153 (47%) | 645 (47%) | 798 (47%) |
| Male | 174 (53%) | 722 (53%) | 896 (53%) |
| Donor CMV serostatus | |||
| Negative | 176 (54%) | 789 (58%) | 965 (57%) |
| Positive | 151 (46%) | 578 (42%) | 729 (43%) |
| HLA | |||
| Matched related | 61 (19%) | 383 (28%) | 444 (26%) |
| Haploidentical | 31 (9%) | 90 (7%) | 121 (7%) |
| Cord | 38 (12%) | 198 (14%) | 236 (14%) |
| Unrelated/mismatched | 197 (60%) | 696 (51%) | 893 (53%) |
| Acute GVHD | |||
| Grade 0-2 | 261 (80%) | 1186 (87%) | 1447 (85%) |
| Grade 3-4 | 66 (20%) | 181 (13%) | 247 (15%) |
| Underlying disease risk by prognostic scoring† | |||
| High | 25 (8%) | 392 (29%) | 417 (25%) |
| Intermediate | 237 (72%) | 112 (8%) | 349 (21%) |
| Low | 65 (20%) | 863 (63%) | 928 (55%) |
| Lowest ALC in 7-90 d before HCT | |||
| Median (IQR) | 230.0 (20.0-670) | 330.0 (0.0-750) | 315.5 (10.0-720) |
| HCT-CI score | |||
| 0-1 | 126 (39%) | 508 (37%) | 634 (37%) |
| 2 | 41 (13%) | 208 (15%) | 249 (15%) |
| ≥3 | 124 (38%) | 581 (43%) | 705 (42%) |
| Unknown | 36 (11%) | 70 (5%) | 106 (6%) |
| Disease | |||
| AA | 15 (5%) | 51 (4%) | 66 (4%) |
| ALL | 53 (16%) | 191 (14%) | 244 (14%) |
| AML | 129 (39%) | 474 (35%) | 603 (36%) |
| CLL/PLL | 1 (0%) | 58 (4%) | 59 (3%) |
| HL | 3 (1%) | 22 (2%) | 25 (1%) |
| MDS | 70 (21%) | 205 (15%) | 275 (16%) |
| MPN | 46 (14%) | 102 (7%) | 148 (9%) |
| NHL | 2 (1%) | 114 (8%) | 116 (7%) |
| Plasma cell neoplasm (MM/PCL) | 5 (2%) | 67 (5%) | 72 (4%) |
| Primary immune deficiency | 1 (0%) | 38 (3%) | 39 (2%) |
| Nonmalignant disorders | 2 (1%) | 45 (3%) | 47 (3%) |
| GHVD prophylaxis | |||
| MMF + CNI | 64 (20%) | 576 (42%) | 640 (38%) |
| MTX + CNI | 117 (36%) | 495 (36%) | 612 (36%) |
| PTCy | 73 (22%) | 129 (9%) | 202 (12%) |
| Other ± CNI | 0 (0%) | 37 (3%) | 37 (2%) |
| Sirolimus based | 73 (22%) | 130 (10%) | 203 (12%) |
| Conditioning | |||
| MAC | 159 (49%) | 789 (58%) | 948 (56%) |
| NMA | 48 (15%) | 310 (23%) | 358 (21%) |
| RIC | 120 (37%) | 268 (20%) | 388 (23%) |
| Transplant no. | |||
| 1 | 317 (97%) | 1180 (86%) | 1497 (88%) |
| >1 | 10 (3%) | 187 (14%) | 197 (12%) |
| Categories . | Letermovir era∗ (n = 327) . | Preemptive therapy era (n = 1367) . | Combined (N = 1694) . |
|---|---|---|---|
| Age at transplant, y | |||
| 0-11 | 0 (0%) | 144 (11%) | 144 (9%) |
| 12-17 | 0 (0%) | 76 (6%) | 76 (4%) |
| 18+ | 327 (100%) | 1147 (84%) | 1474 (87%) |
| Race | |||
| White | 242 (74%) | 1043 (76%) | 1285 (76%) |
| American Indian or Alaska Native | 4 (1%) | 29 (2%) | 33 (2%) |
| Asian | 37 (11%) | 141 (10%) | 178 (11%) |
| Black or African American | 9 (3%) | 40 (3%) | 49 (3%) |
| Multiple | 7 (2%) | 36 (3%) | 43 (3%) |
| Native Hawaiian or other Pacific Islander | 7 (2%) | 25 (2%) | 32 (2%) |
| Unknown | 21 (6%) | 53 (4%) | 74 (4%) |
| Ethnicity | |||
| Hispanic or Latino | 34 (10%) | 130 (10%) | 164 (10%) |
| Not Hispanic or Latino | 274 (84%) | 1194 (87%) | 1468 (87%) |
| Unknown | 19 (6%) | 43 (3%) | 62 (4%) |
| Sex | |||
| Female | 153 (47%) | 645 (47%) | 798 (47%) |
| Male | 174 (53%) | 722 (53%) | 896 (53%) |
| Donor CMV serostatus | |||
| Negative | 176 (54%) | 789 (58%) | 965 (57%) |
| Positive | 151 (46%) | 578 (42%) | 729 (43%) |
| HLA | |||
| Matched related | 61 (19%) | 383 (28%) | 444 (26%) |
| Haploidentical | 31 (9%) | 90 (7%) | 121 (7%) |
| Cord | 38 (12%) | 198 (14%) | 236 (14%) |
| Unrelated/mismatched | 197 (60%) | 696 (51%) | 893 (53%) |
| Acute GVHD | |||
| Grade 0-2 | 261 (80%) | 1186 (87%) | 1447 (85%) |
| Grade 3-4 | 66 (20%) | 181 (13%) | 247 (15%) |
| Underlying disease risk by prognostic scoring† | |||
| High | 25 (8%) | 392 (29%) | 417 (25%) |
| Intermediate | 237 (72%) | 112 (8%) | 349 (21%) |
| Low | 65 (20%) | 863 (63%) | 928 (55%) |
| Lowest ALC in 7-90 d before HCT | |||
| Median (IQR) | 230.0 (20.0-670) | 330.0 (0.0-750) | 315.5 (10.0-720) |
| HCT-CI score | |||
| 0-1 | 126 (39%) | 508 (37%) | 634 (37%) |
| 2 | 41 (13%) | 208 (15%) | 249 (15%) |
| ≥3 | 124 (38%) | 581 (43%) | 705 (42%) |
| Unknown | 36 (11%) | 70 (5%) | 106 (6%) |
| Disease | |||
| AA | 15 (5%) | 51 (4%) | 66 (4%) |
| ALL | 53 (16%) | 191 (14%) | 244 (14%) |
| AML | 129 (39%) | 474 (35%) | 603 (36%) |
| CLL/PLL | 1 (0%) | 58 (4%) | 59 (3%) |
| HL | 3 (1%) | 22 (2%) | 25 (1%) |
| MDS | 70 (21%) | 205 (15%) | 275 (16%) |
| MPN | 46 (14%) | 102 (7%) | 148 (9%) |
| NHL | 2 (1%) | 114 (8%) | 116 (7%) |
| Plasma cell neoplasm (MM/PCL) | 5 (2%) | 67 (5%) | 72 (4%) |
| Primary immune deficiency | 1 (0%) | 38 (3%) | 39 (2%) |
| Nonmalignant disorders | 2 (1%) | 45 (3%) | 47 (3%) |
| GHVD prophylaxis | |||
| MMF + CNI | 64 (20%) | 576 (42%) | 640 (38%) |
| MTX + CNI | 117 (36%) | 495 (36%) | 612 (36%) |
| PTCy | 73 (22%) | 129 (9%) | 202 (12%) |
| Other ± CNI | 0 (0%) | 37 (3%) | 37 (2%) |
| Sirolimus based | 73 (22%) | 130 (10%) | 203 (12%) |
| Conditioning | |||
| MAC | 159 (49%) | 789 (58%) | 948 (56%) |
| NMA | 48 (15%) | 310 (23%) | 358 (21%) |
| RIC | 120 (37%) | 268 (20%) | 388 (23%) |
| Transplant no. | |||
| 1 | 317 (97%) | 1180 (86%) | 1497 (88%) |
| >1 | 10 (3%) | 187 (14%) | 197 (12%) |
AA, aplastic anemia; ALC, absolute lymphocyte count; ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; CLL, chronic myelogenous leukemia; CNI, calcineurin inhibitor; HL, Hodgkin lymphoma; IQR, interquartile range; MAC, myeloablative conditioning; MDS, myelodysplastic syndrome; MM, multiple myeloma; MMF, mycophenolate mofetil; MPN, myeloproliferative neoplasm; MTX, methotrexate; NHL, non-Hodgkin lymphoma; NMA, nonmyeloablative conditioning; PLL, prolymphocytic leukemia; PTCy, posttransplantation cyclophosphamide; RIC, reduced-intensity conditioning.
A total of 342 patients from the letermovir era were evaluated for risk factors for pre-HCT CMV, but only the subset included in the predictive analyses for post-HCT CMV reactivation (n = 327) are shown in Table 1.
Underlying disease risk was based upon prognostic scoring systems used institutionally for each respective disease.