Management of cytomegalovirus in hematopoietic stem cell transplant recipients: A review of novel pharmacologic and cellular therapies

Background: Despite diagnostic and therapeutic advances, cytomegalovirus (CMV) infection has remained a significant complication after hematopoietic stem cell transplantation (HSCT). The widespread use of pre-emptive antiviral therapy has reduced, but not eliminated, the occurrence of early CMV infection. The epidemiological shift of CMV infection, requiring repeated and prolonged treatment courses, creates an increasing need for novel antiviral drugs. This is an exciting time in the evolution of pharmacologic anti-CMV therapies. Objective: This review article provides an update on the therapeutic options for treatment of CMV in HSCT recipients, focusing on new pharmacologic agents—including maribavir, letermovir, brincidofovir, leflunomide, and artesunate—as well on as the emerging concept of cellular therapies and the future of a CMV vaccine. Results: In the past few years, encouraging preliminary data has emerged for both new pharmacologic therapies and cellular therapies; however, current evidence doe...