CMV-TCIP Directed Letermovir Prophylaxis After Allo-SCT

Inclusion criteria

• ≥ 18 years of age on the day of signing informed consent.
• Karnofsky performance >70%
• Have documented seropositivity for CMV (either donor or recipient CMV IgG seropositivity) before AHCT.
• Eligible for AHCT from an HLA-matched related, matched unrelated, mismatched unrelated or haploidentical donor using either bone marrow or peripheral blood stem cells.
• Have undetectable CMV DNA from a plasma sample collected within 5 days prior to enrollment.
• Must be within Day-10 thru Day+28 days of planned HSCT at the time of enrollment.
• Be able to comply with medical recommendations or follow-up.
• Has adequate organ functions determined by

• Serum creatinine clearance ≥50 ml/min (calculated with Cockroft-Gault formula).
• Bilirubin ≤1.5 mg/dl except for Gilbert's disease.
• ALT or AST ≤200 IU/ml for adults.
• Conjugated (direct) bilirubin < 2x upper limit of normal.
• Left ventricular ejection fraction ≥40%.
• Diffusing capacity for carbon monoxide (DLCO) ≥ 50% predicted corrected for hemoglobin.

Exclusion criteria

• Has a history of CMV end-organ disease or CS-CMVi within 6 months prior to enrollment.
• Received within 7 days prior to screening or plans to receive during the study any of the following:

• Ganciclovir
• Valganciclovir
• Foscarnet
• Acyclovir (> 3200 mg PO per day or > 25 mg/kg IV per day)
• Valacyclovir (> 3000 mg/day)
• Famciclovir (> 1500 mg/day)
• Received within 30 days prior to screening or plans to receive during the study any of the following drugs: cidofovir, CMV hyper-immune globulin, any investigational CMV antiviral agent/biologic therapy.
• Has suspected or known hypersensitivity to active or inactive ingredients of letermovir formulations.
• Has an uncontrolled infection
• Requires mechanical ventilation or is hemodynamically unstable