Cytovene (ganciclovir) / Roche - LARVOL DELTA

THE PERFECT STORM: AN UNEXPECTED CAUSE OF POST-TRANSPLANT ACUTE KIDNEY INJURY FROM CMV-INDUCED MACROPHAGE ACTIVATION SYNDROME (ISN-WCN 2026) - "Her post-transplant course was complicated by antibody mediated rejection 2-months post-transplant, successfully treated with pulse steroids, plasmapheresis, IVIG and rituximab. She was maintained on mycophenolic acid 720 mg twice a day, tacrolimus 2 mg twice a day and prednisone 5 mg daily. Unexpectedly, 5-months post-transplant, she developed an acute febrile illness and cough with hemoptysis, diagnosed with Bordetella pertussis, treated with Azithromycin...Treatment with IV ganciclovir was initiated, with improvement of pancytopenia. Maintenance valganciclovir was continued and renal function returned to prior baseline.Results See aboveConclusion Macrophage activation syndrome (MAS) is a life-threatening hyperinflammatory condition...In our case, allograft dysfunction and pancytopenia heralded the detection of CMV viremia. Targeted anti-viral therapy led to resolution of CMV infection and complete recovery of renal allograft function."

Post-transplantation • Acute Kidney Injury • Antibody-mediated Rejection • Cough • Cytomegalovirus Infection • Epstein-Barr Virus Infections • Glomerulonephritis • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Immunology • Infectious Disease • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology • Pertussis • Rare Diseases • Renal Disease • Respiratory Diseases • Systemic Inflammatory Response Syndrome • Transplantation • CD8 • IFNG • IL6 • TNFA

LDL APHERESIS FACILITATES DIALYSIS INDEPENDENCE IN PODOCYTOPATHY-ASSOCIATED ACUTE KIDNEY INJURY: TWO CASE REPORTS (ISN-WCN 2026) - "Rituximab was administered on days 17 and 24...Steroid-induced diabetes and cytomegalovirus antigenemia were treated with temporary insulin and ganciclovir, respectively.Conclusion In two cases of podocytopathy-associated nephrotic syndrome complicated by dialysis-dependent acute kidney injury, LDL-apheresis promoted improvement in proteinuria and renal function, allowing for the withdrawal of dialysis...This modality may support individualized therapy in older or high-risk patients by enabling earlier steroid tapering and reducing the need for additional immunosuppression therapy. Further studies are needed to clarify patient selection, optimal timing, and comparative efficacy."

Case report • Clinical • Acute Kidney Injury • Breast Cancer • Chronic Kidney Disease • Cytomegalovirus Infection • Diabetes • Dyslipidemia • Focal Segmental Glomerulosclerosis • Gastroenterology • Gastrointestinal Disorder • Glomerulonephritis • Immunology • Infectious Disease • Metabolic Disorders • Nephrology • Renal Disease • Solid Tumor

Nanocarriers for potential treatment of sensorineural hearing loss and retinitis in congenital cytomegalovirus. (PubMed, Nanomedicine (Lond)) - "Newer agents are under investigation to develop alternative treatments for cCMV. The current evidence supports the development of new strategies in nanomedicines to be used either alone or in combination with ganciclovir and oral valganciclovir."

Journal • Review • Cytomegalovirus Infection • Genetic Disorders • Infectious Disease • Ocular Inflammation • Ophthalmology • Otorhinolaryngology • Pediatrics • Retinal Disorders

Factors influencing ganciclovir trough concentrations during prophylaxis or therapy of CMV infections (ESCMID Global 2026) - No abstract available

Cytomegalovirus Infection • Infectious Disease

Decoding the antiviral potential of eugenol, thymol and vanillin against human cytomegalovirus infection. (PubMed, J Gen Virol) - "The eugenol/ganciclovir combination was particularly effective in ARPE-19 cells, while thymol/ganciclovir showed enhanced efficacy in MRC-5 cells. These findings suggest that EOCs have significant potential as adjunct therapies to improve antiviral outcomes and address drug-resistant HCMV strains."

Journal • Cytomegalovirus Infection • Infectious Disease

Disruption of the oligodendroglial miR-126a-3p-Pex5 axis inhibits remyelination in chronic demyelinating lesions. (PubMed, Sci Transl Med) - "A screening of a US Food and Drug Administration-approved drug library based on Pex5 levels led to the identification of ganciclovir, an antiviral agent, as a potent proremyelinating agent after in vivo demyelinating events. These results identify the aberrant miR-126a-3p-Pex5 axis in oligodendroglia as a potential therapeutic target to facilitate remyelination in chronic MS lesions."

Journal • CNS Disorders • Immunology • Multiple Sclerosis • Solid Tumor

Chronic Gastric Ulceration Due to Cytomegalovirus in Immunocompetent Adults - A Case Report and Systematic Review. (PubMed, Rev Med Virol) - "This case report and systematic review describe the complete clinical course of chronic gastric ulceration complicating acute gastrointestinal CMV disease in a 72-year-old immunocompetent woman, with demonstrable response to ganciclovir but not valganciclovir. Finally, CMV may represent an under-recognised and treatable contributor to the increasing cohort of patients, particularly older patients, with Helicobacter pylori and non-steroidal anti-inflammatory drug negative gastric ulcers, though CMV-associated gastric ulcers remain rare overall. Accordingly, diagnosis requires a high index of suspicion, with pursuit of CMV PCR and/or immunohistochemistry of gastric ulcer biopsies strongly encouraged."

Journal • Review • Cytomegalovirus Infection • Gastroenterology • Infectious Disease • Peptic Ulcer

BUSULFAN ASSOCIATED PULMONARY TOXICITY AND INFECTIOUS COMPLICATIONS FOLLOWING AUTOLOGOUS SCT IN A 3-YEAR-OLD CHILD WITH NEUROBLASTOMA (EBMT 2026) - "Background: High-dose busulfan/melphalan (Bu/Mel) remains a standard conditioning regimen for autologous stem cell transplantation in high-risk neuroblastoma but is associated with significant organ toxicity, particularly hepatic and pulmonary injury...A treatment with Defibrotide, Ganciclovir and Azithromycin was initiated...We started a treatment with Sildenafil, Macitentan, Epoprostenol in addition to Methylprednisolone pulse therapy and antifibrotic treatment with Nintedanib, Hydroxychloroquin and Azithromycin... This case illustrates the complex interplay between infectious complications, post-transplant inflammation and busulfan-induced pulmonary toxicity in a young neuroblastoma patient undergoing Bu/Mel conditioning and autologous SCT. Consideration of busulfan toxicities, especially when presenting with nonspecific early symptoms is important even when alternative explanations such as severe infection may appear equally plausible after autologous SCT. Early..."

Clinical • Acute Respiratory Distress Syndrome • Cardiovascular • Cystic Fibrosis • Cytomegalovirus Infection • Gastroenterology • Genetic Disorders • Hepatology • Immunology • Infectious Disease • Inflammation • Interstitial Lung Disease • Neuroblastoma • Pneumonia • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Septic Shock • Solid Tumor

Cytomegalovirus Infection Mimics Manifestations of Underlying Diseases in Patients With Autoimmune Disorders: A Case Report and Literature Review. (PubMed, Immun Inflamm Dis) - "CMV infection in patients with inflammatory rheumatic diseases may lead to rare manifestations that can be misdiagnosed as a flare of the underlying disease."

Journal • Review • Cytomegalovirus Infection • Hematological Disorders • Herpes Simplex • Immunology • Infectious Disease • Inflammatory Arthritis • Leukopenia • Lupus • Pain • Rheumatology • Sarcoidosis • Systemic Lupus Erythematosus

TRIAL IN PROGRESS: A PHASE 2, SINGLE-ARM, MULTICENTER STUDY OF MARIBAVIR FOR CYTOMEGALOVIRUS INFECTION IN PATIENTS WITH LYMPHOID MALIGNANCIES UNDERGOING BISPECIFIC ANTIBODIES (MALMBA) (EBMT 2026) - P2 | "Unlike conventional CMV agents such as ganciclovir, cidofovir, and foscarnet—often restricted by myelosuppression or renal toxicity—maribavir provides robust antiviral activity without hematologic toxicity, supporting its use in immunocompromised populations. No data are available at this stage as the trial is ongoing."

Bispecific • Clinical • P2 data • B Cell Lymphoma • Cytomegalovirus Infection • Hematological Malignancies • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Liver Failure • Lymphoma • Multiple Myeloma • Non-Hodgkin’s Lymphoma • Oncology • CD4 • CD8 • IFNG

LETERMOVIR USE IN PEDIATRIC HSCT PATIENTS UNDER 12 YEARS OLD: UPDATED DATA FROM A RETROSPECTIVE MULTICENTER STUDY OF THE PDWP AND IEWP OF THE EBMT (EBMT 2026) - "Conditioning regimens included treosulfan-based (44.5%), TBI-based (32.2%), busulfan-based (15.1%), and other (8.2%). In-vivo T-cell depletion (TCD) was used in 34.2% of patients (ATG 27.4%, Campath 6.8%), and ex-vivo TCD in 11.6%.Table 1: Patient and transplant characteristics With a median follow-up of 1 year (95% CI: 0.9–1.1), the 1-year cumulative incidence of CMV reactivation was 23.8% (95% CI: 16–30) overall, 21.4% (95% CI: 13.6–29.2) during primary prophylaxis, and 32.6% (95% CI: 13.1–45) during secondary prophylaxis (Figure 1)...Among patients with CMV reactivation, one death was attributed to relapsed disease.Letermovir was well tolerated with only two patients experiencing mild gastrointestinal toxicity, and no additional significant adverse events reported.CMV reactivations were managed using standard antiviral strategies, including valganciclovir (n=10), ganciclovir (n=8), foscarnet (n=7), and cidofovir (n=1) or continued letermovir alone (n=8)... In this..."

Retrospective data • Bone Marrow Transplantation • Cytomegalovirus Infection • Graft versus Host Disease • Hepatology • Immunology • Infectious Disease • Pediatrics

REAL-WORLD UTILIZATION AND EFFICACY OF BIOEQUIVALENT GENERIC LETERMOVIR PROPHYLAXIS IN ALLOGENEIC HSCT RECIPIENTS: PEDIATRIC SUBGROUP ANALYSIS FROM DEFENDER STUDY (EBMT 2026) - "Pre-emptive therapy was required in 13 patients (12.87%), primarily ganciclovir (10.89%) and cidofovir (1.98%). Letermovir prophylaxis demonstrated acceptable efficacy and excellent tolerability in pediatric allo-HSCT recipients, with low adverse event rates and high completion rates. Real-world data support letermovir use in pediatric transplant populations and highlight the need for individualized dosing strategies."

Clinical • Real-world • Real-world evidence • Acute Graft versus Host Disease • Bone Marrow Transplantation • Cytomegalovirus Infection • Genetic Disorders • Graft versus Host Disease • Hematological Disorders • Hematological Malignancies • Immunology • Leukemia • Pediatrics • Sickle Cell Disease

REAL-WORLD UTILIZATION AND EFFICACY OF BIOEQUIVALENT GENERIC LETERMOVIR PROPHYLAXIS IN ALLOGENEIC HSCT RECIPIENTS: PEDIATRIC SUBGROUP ANALYSIS FROM DEFENDER STUDY (EBMT 2026) - "Pre-emptive therapy was required in 13 patients (12.87%), primarily ganciclovir (10.89%) and cidofovir (1.98%). Letermovir prophylaxis demonstrated acceptable efficacy and excellent tolerability in pediatric allo-HSCT recipients, with low adverse event rates and high completion rates. Real-world data support letermovir use in pediatric transplant populations and highlight the need for individualized dosing strategies."

Clinical • Real-world • Real-world evidence • Acute Graft versus Host Disease • Bone Marrow Transplantation • Cytomegalovirus Infection • Genetic Disorders • Graft versus Host Disease • Hematological Disorders • Hematological Malignancies • Immunology • Leukemia • Pediatrics • Sickle Cell Disease

Dynamic Mixed Populations of Resistant CMV in a Lung Transplant Recipient (ISHLT 2026) - "Despite these changes he required IV ganciclovir for rising viral loads, and after initial testing showed resistance only to cidofovir, the patient was transitioned back to valganciclovir...The patient once again developed viremia, and testing now showed resistance to maribavir, ganciclovir, and cidofovir for which foscarnet was restarted...Viral loads improved, and the patient was eventually transitioned to a letermovir/valganciclovir combination therapy, followed by maribavir/letermovir therapy after testing showed his maribavir resistance had resolved. Subsequent surveillance has shown CMV viral levels managed on dual therapy.Summary Prior literature has shown that antiviral therapy can select for resistant strains if mixed populations are present, leading to changes in genotypic susceptibility testing results over time. We present a case of highly resistance mixed genotype CMV populations with changing resistance profiles, that was successfully treated with salvage..."

Clinical • Fibrosis • Immunology • Inflammation • Pneumonia • Pulmonary Disease • Transplantation

LOW-DOSE WEEKLY CIDOFOVIR AS AN EFFECTIVE PROPHYLACTIC ALTERNATIVE TO LETERMOVIR FOR PRE-ENGRAFTMENT CMV IN ALLOGENEIC HSCT (EBMT 2026) - "In a direct efficacy comparison, low-dose weekly cidofovir demonstrates breakthrough rates and a safety profile akin to letermovir for pre-engraftment CMV prophylaxis. For geographical regions where letermovir is unavailable or cost-prohibitive, this protocol provides a highly effective, practical, and cost-conscious prophylactic alternative, potentially mitigating early CMV-related graft compromise without the myelosuppressive risks of ganciclovir. It warrants consideration as a strategic option in global transplant practice."

Bone Marrow Transplantation • Cytomegalovirus Infection • Infectious Disease

REAL-WORLD UTILIZATION AND EFFICACY OF LETERMOVIR PROPHYLAXIS IN ADULT ALLOGENEIC HAEMATOPOIETIC STEM CELL TRANSPLANT RECIPIENTS: SUBGROUP ANALYSIS DEFENDER STUDY (EBMT 2026) - "GVHD prophylaxis included post-transplant cyclophosphamide (63.64%), tacrolimus (45.45%), cyclosporine (41.82%), and mycophenolate mofetil (38.18%)...Pre-emptive therapy was given to 25.45%: ganciclovir (14.55%), valganciclovir (7.27%), cidofovir (3.64%)... Bioequivalent Generic Letermovir (Anvimo) prophylaxis in adult allo-HSCT recipients demonstrated favourable real-world effectiveness with low rates of CMV reactivation and clinically significant reactivation. The 100-day survival rate and low adverse event profile support the safety and tolerability of letermovir in routine clinical practice."

Clinical • Real-world • Real-world evidence • Acute Graft versus Host Disease • Bone Marrow Transplantation • Cytomegalovirus Infection • Graft versus Host Disease • Hematological Malignancies • Immunology • Transplantation

LOW-DOSE WEEKLY CIDOFOVIR AS AN EFFECTIVE PROPHYLACTIC ALTERNATIVE TO LETERMOVIR FOR PRE-ENGRAFTMENT CMV IN ALLOGENEIC HSCT (EBMT 2026) - "In a direct efficacy comparison, low-dose weekly cidofovir demonstrates breakthrough rates and a safety profile akin to letermovir for pre-engraftment CMV prophylaxis. For geographical regions where letermovir is unavailable or cost-prohibitive, this protocol provides a highly effective, practical, and cost-conscious prophylactic alternative, potentially mitigating early CMV-related graft compromise without the myelosuppressive risks of ganciclovir. It warrants consideration as a strategic option in global transplant practice."

Bone Marrow Transplantation • Cytomegalovirus Infection • Infectious Disease

CMV-Triggered HLH in a Healthy Nurse Leading to Life-Threatening ARDS: A Rare Immune Case (SCCM 2026) - "He was initially treated with levofloxacin for presumed community-acquired pneumonia, but symptoms worsened...Karius testing confirmed CMV viremia; ganciclovir was initiated...CMV is a rare but important trigger of HLH in otherwise healthy hosts. Early recognition and timely initiation of immunosuppressive therapy are essential for improving outcomes in this potentially fatal condition."

Clinical • Acute Respiratory Distress Syndrome • Addiction (Opioid and Alcohol) • Cough • Cytomegalovirus Infection • Dyslipidemia • Hypertriglyceridemia • Immunology • Infectious Disease • Leukopenia • Pneumonia • Respiratory Diseases • Thrombocytopenia • IL2 • ISG20

Two Bugs, One Brain: A Viral and Bacterial Tug-of-War in an HIV Patient (SCCM 2026) - "He clinically improved with Rocephin, but mentation declined after completing antibiotic course...He was initiated on ganciclovir, which drastically improved the patient's mentation. This case highlights the diagnostic challenges in immunocompromised patients who have muted immune responses with non-specific symptoms...This is reiterating the diagnostic dilemma in recognizing infections with overlapping symptoms and the importance of methodical approach for appropriate patient care. This emphasizes the importance of proactive preventative strategies such as vaccinations and ART to reduce the risk of severe infections."

Clinical • CNS Disorders • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Pneumococcal Infections • Pneumonia • CD4

Renal Artery Stenosis Secondary to Cytomegalovirus Infection in an Infant. (PubMed, JACC Case Rep) - "CMV infection should be considered in infants presenting with unexplained renal artery stenosis. Early antiviral therapy may lead to complete reversibility without invasive intervention."

Journal • Cardiovascular • Cytomegalovirus Infection • Epilepsy • Hypertension • Infectious Disease • Transplantation

Triple Infections With Campylobacter coli, Cytomegalovirus, and SARS-CoV-2 in a Lymphoma Patient Treated With Epcoritamab. (PubMed, Cureus) - "Chemoimmunotherapy for malignant lymphoma, including corticosteroids, rituximab (R), and Bruton's tyrosine kinase inhibitors, depletes normal lymphocytes and disrupts lymphocyte function...We treated a case of relapsed malignant lymphoma, infected with triple infections, Campylobacter coli, Cytomegalovirus, and SARS-CoV-2, during treatment with epcoritamab after standard chemoimmunotherapies, including R-cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP), and R-bendamustine...His treatment for infections included remdesivir, meropenem, and ganciclovir...Epcoritamab can demonstrate long-standing B-cell depletion; however, a long-term influence on T cells is still elusive. This case suggested that we should pay special attention to patients with B-cell manipulating therapy including R, CAR-T, and BiTEs such as epcoritamab."

Journal • Cytomegalovirus Infection • Gastrointestinal Disorder • Hematological Disorders • Hematological Malignancies • Infectious Disease • Lymphoma • Novel Coronavirus Disease • Oncology • Pneumonia • Respiratory Diseases • CD20

Maribavir use in managing cytomegalovirus infection among UK kidney transplant recipients (UKKW 2026) - "Refractory CMV encompasses CMV infection which is resistant (either suspected or confirmed) to first line treatments, with UL97 gene mutations being resistant to valganciclovir and ganciclovir. Maribavir is an effective and well tolerated oral option to treat refractory CMV in an outpatient setting, avoiding the associated costs of hospital facilities and reducing the need for nephrotoxic or myelotoxic alternatives. The average treatment duration reflects reports from the SOLSTICE trial, however real- world data highlights high reactivation rates post treatment, and strengthens the importance of close PCR monitoring following treatment cessation. Reported adverse effects were similar to the trials, but demonstrates the need for pre- emptive tacrolimus dose alterations to avoid toxicity and its associated nephrotoxicity."

Clinical • Cytomegalovirus Infection • Infectious Disease • Transplantation

LETERMOVIR FOR CYTOMEGALOVIRUS PREVENTION IN RELAPSED/REFRACTORY ACUTE LEUKEMIA AND LYMPHOMA RECEIVING SEQUENTIAL CD7 CAR-T CELL THERAPY BRIDGING ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION (EBMT 2026) - "The treatment dose was letermovir 480 mg qd, reduced to 240 mg qd for patients concurrently taking cyclosporine...One patient (11.1%) experienced a breakthrough CMV infection on day 14 post-transplantation, with an initial CMV DNA load of 914 copies/mL; the infection resolved after 2 days of adjunctive ganciclovir therapy, with subsequent CMV DNA conversion to negative... In a real-world setting, letermovir demonstrated significant efficacy in preventing CMV infection in patients with acute leukemia and lymphoma undergoing sequential CD7 CAR-T cell therapy bridging allo-HSCT. The high risk of CMV reactivation post-CAR-T therapy has been confirmed in multiple studies. The CMV infection rate observed in this study is significantly lower than previously reported rates for CD7 CAR-T bridging transplantation."

CAR T-Cell Therapy • Acute Lymphocytic Leukemia • Bone Marrow Transplantation • Cytomegalovirus Infection • Epstein-Barr Virus Infections • Hematological Disorders • Hematological Malignancies • Infectious Disease • Leukemia • Lymphoma • T Acute Lymphoblastic Leukemia • T-cell Acute Lymphoblastic Lymphoma • Transplantation • CD7

EFFICACY AND SAFETY OF MARIBAVIR IN HEMATOPOIETIC CELL TRANSPLANT RECIPIENTS BY BASELINE NEUTROPENIA STATUS: A POST HOC ANALYSIS OF PHASE 2 AND 3 CLINICAL TRIALS (EBMT 2026) - P2, P3 | "Clinical Trial Registry: NCT01611974, https://clinicaltrials.gov/study/NCT01611974NCT02931539, https://www.clinicaltrials.gov/study/NCT02931539 Background: Recipients of hematopoietic cell transplantation (HCT) are susceptible to myelotoxicity associated with anti-cytomegalovirus (CMV) agents such as ganciclovir or valganciclovir. This post hoc analysis of phase 2 and 3 clinical data in HCT recipients with refractory CMV infection showed no statistically significant differences in time to CMV DNAemia clearance and broadly similar overall AE profiles in maribavir-treated patients with and without baseline neutropenia. Although these findings are based on small sample sizes, especially in the neutropenia groups, they support the use of maribavir as a therapeutic option in HCT recipients with refractory CMV infection, regardless of neutropenia, and warrant further research."

Clinical • P2 data • Retrospective data • Bone Marrow Transplantation • Cytomegalovirus Infection • Hematological Disorders • Infectious Disease • Neutropenia • Transplantation

PHYSICIAN SURVEY OF REAL-WORLD MARIBAVIR USE AND TREATMENT DECISION MAKING IN REFRACTORY CYTOMEGALOVIRUS INFECTION AFTER TRANSPLANTATION (EBMT 2026) - P3 | "The anti-CMV agent maribavir has shown higher clearance rates and lower incidence of myelosuppression compared with ganciclovir/valganciclovir in transplant recipients with RR CMV infection in a randomized clinical trial (NCT02931539). Survey findings indicate variability and perceived gaps between guidelines and clinical practice in the management of RR CMV infection following transplantation. Following the introduction of new treatment options, physicians reported a tendency to switch earlier to maribavir if the current agent was ineffective or to avoid toxicity. These results highlight the need for treatment options that achieve CMV clearance with fewer treatment-related toxicities, and for practical guidance on optimizing maribavir use in real-world practice."

Clinical • Real-world • Real-world evidence • Cytomegalovirus Infection • Hematological Disorders • Infectious Disease • Nephrology • Transplantation