Adjuvant and salvage therapy with leflunomide for recalcitrant cytomegalovirus infections in hematopoietic cell transplantation recipients: A case series

Firas El Chaer, Nobuyoshi Mori, Dimpy P Shah, Nora Oliver, Emily Wang, Anna Jan, Vi Doan, Frank Tverdek, Jean Tayar, Ella Ariza-Heredia, Roy F. Chemaly

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9 Scopus citations

Abstract

Cytomegalovirus (CMV) reactivation is a clinically significant complication in hematopoietic stem cell transplant (HCT) recipients. Alternative therapy for multidrug-resistant CMV is limited and often fails. Leflunomide has been used to treat resistant CMV infections, however, data on efficacy, safety, and guidance for therapeutic drug level monitoring are lacking. In this report, we describe 3 HCT recipients with multi-drug resistant CMV infections who received leflunomide as adjuvant and salvage therapy. The therapeutic effect of leflunomide as an anti-CMV agent based on virologic responses and therapeutic drug monitoring were evaluated.

Original languageEnglish (US)
Pages (from-to)91-96
Number of pages6
JournalAntiviral Research
Volume135
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

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Keywords

  • Cytomegalovirus
  • Drug level
  • Leflunomide
  • Resistance
  • Stem cell transplant

ASJC Scopus subject areas

  • Pharmacology
  • Virology

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