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Cytomegalovirus reactivation after bortezomib treatment for multiple myeloma and light chain amyloidosis

Sharpley, FA; De-Silva, D; Mahmood, S; Sachchithanantham, S; Ramsay, I; Garcia Mingo, A; Worthington, S; ... D Wechalekar, A; + view all (2020) Cytomegalovirus reactivation after bortezomib treatment for multiple myeloma and light chain amyloidosis. European Journal of Haematology , 104 (3) pp. 230-235. 10.1111/ejh.13366. Green open access

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Abstract

Objective: Cytomegalovirus (CMV) is an opportunistic herpesvirus, and reactivation of infection is possible in immunocompromised patients. Historically, the risk for haematology patients is restricted to those treated with an allogeneic transplant or T‐cell depleting agents. Bortezomib is a highly efficacious proteasome inhibitor widely used to treat multiple myeloma and light chain (AL) amyloidosis patients. The objective of this small prospective study was to quantify the risk of CMV reactivation associated with bortezomib treatment. Methods: Fifty‐seven consecutive multiple myeloma or AL amyloidosis patients commencing bortezomib‐based therapy were included. Viral copy numbers were established at baseline and then at fortnightly intervals during treatment. Pre‐emptive anti‐viral treatment was initiated in patients with a viral load >7500 copies/mL. Results: Reactivation of CMV was detected in 39% (n = 12/31) of seropositive bortezomib treated patients compared with 0% of CMV seronegative patients. Detectable DNAemia developed during the first two cycles of treatment in 83% (n = 10/12) patients. Anti‐viral treatment was initiated in 42% (n = 5/12), but no cases of active CMV disease were seen. Conclusion: This study suggests that there is a substantial risk of CMV reactivation in CMV‐seropositive plasma cell dyscrasia patients treated with bortezomib.

Type: Article
Title: Cytomegalovirus reactivation after bortezomib treatment for multiple myeloma and light chain amyloidosis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/ejh.13366
Publisher version: https://doi.org/10.1111/ejh.13366
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10088200
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