Transplant & Oncology ID: Literature Dives

09: Interferon-γ Release Assays for TB in Cancer Patients

This research article retrospectively analyzes interferon-gamma release assay (IGRA) test results (QuantiFERON-TB and T-SPOT.TB) from cancer patients to determine their effectiveness in diagnosing tuberculosis (TB). The study at a major US cancer center found T-SPOT.TB yielded significantly more actionable results than QFT-TB, with QFT-TB producing a high rate of indeterminate results. Several factors, including immunosuppressant use and low hemoglobin, were associated with IGRA test invalidity or indeterminacy. While T-SPOT.TB showed better diagnostic performance for latent TB infection, the low TB disease prevalence limited conclusions on its ability to predict progression to active disease. The findings highlight the need for improved diagnostic tools for TB in immunocompromised individuals. Batista MV, Sassine J, Khawaja F, et al. The Utility of Interferon-γ Release Assays in the Diagnosis of Tuberculosis in Patients With Cancer. Transpl Infect Dis 2024;e14428. PMID: 39731624 [https://pubmed.ncbi.nlm.nih.gov/39731624/] Created with NotebookLM by Google so there may be mistakes and/or errors.

08: Antibody Response to RSV Vaccines in Immunocompromised Adults

This study investigates the antibody response to respiratory syncytial virus (RSV) vaccines in immunocompromised individuals. Researchers measured antibody levels in a cohort of immunocompromised adults after receiving either an adjuvanted or non-adjuvanted RSV vaccine. Results showed heterogeneous antibody responses, with a significant portion not achieving seroconversion or a high-titer neutralization threshold. The adjuvanted vaccine showed better results. Study limitations included a small sample size and lack of cellular data. The findings suggest a need for further investigation into optimizing RSV vaccination strategies for immunocompromised populations. Created with NotebookLM by Google so there may be mistakes and/or errors. PMID: 39786402 [https://pubmed.ncbi.nlm.nih.gov/39786402/] Karaba AH, Hage C, Sengsouk I, et al. Antibody Response to Respiratory Syncytial Virus Vaccination in Immunocompromised Persons. JAMA 2024.

07: Maribavir for Refractory CMV in SOT

This article presents a subgroup analysis of the phase 3 SOLSTICE clinical trial, focusing on solid organ transplant recipients treated with maribavir for refractory cytomegalovirus (CMV) infection. The study compared maribavir to investigator-assigned therapy, assessing efficacy in CMV viremia clearance and safety, including treatment-emergent adverse events and the development of maribavir resistance. Results showed maribavir's superiority in CMV clearance across various transplant types and fewer treatment discontinuations compared to standard treatments. The findings support maribavir's effectiveness and safety profile in this specific patient population. Limitations of the open-label design and sample size are acknowledged. PMID: 39613120 [https://pubmed.ncbi.nlm.nih.gov/39613120/] Blumberg EA, Witzke O, Harber M, et al. Maribavir for refractory cytomegalovirus infection (with or without resistance) in solid organ transplant recipients: Subgroup analysis of the phase 3 randomized SOLSTICE study. J Heart Lung Transplant 2024;S1053-2498(24)01971-5. Created with NotebookLM by Google so there may be mistakes and/or errors.

06: Adenovirus After Allo HCT

This study, published in Bone Marrow Transplantation, analyzes adenovirus (ADV) infections in children and adults after allogeneic hematopoietic cell transplantation (allo-HCT). Researchers examined 2529 patients from the EBMT database, identifying risk factors for mortality. Children demonstrated better short-term survival than adults, with different factors influencing mortality in each group. In children, pre-transplant factors like CMV serostatus and performance score were key, whereas in adults, factors directly related to ADV infection, such as the type of infection and time of onset, were more impactful. The study highlights the need for regular ADV screening in both children and adults post-allo-HCT. Created with NotebookLM by Google so there may be mistakes and/or errors. PMID: 38987308 [https://pubmed.ncbi.nlm.nih.gov/38987308/] Styczynski J, Tridello G, Knelange N, et al. Adenovirus infections after allogeneic hematopoietic cell transplantation in children and adults: a study from the Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 2024;59(10):1402–12.

05: Extended Infusion Beta Lactams for F&N

This research article reports on a randomized clinical trial (BEATLE) investigating the efficacy of extended-infusion versus intermittent-infusion β-lactam antibiotics in treating febrile neutropenia in hematological patients. The study, conducted across four Spanish hospitals, aimed to determine if extended infusion improved treatment success, defined as defervescence without antibiotic changes. Results showed no significant difference in treatment success between the two groups. However, extended infusion achieved higher pharmacokinetic/pharmacodynamic targets for susceptible Pseudomonas aeruginosa. The authors conclude that extended infusion isn't routinely warranted but may benefit patients with infections caused by less susceptible microorganisms. Created with NotebookLM by Google so there may be mistakes and/or errors. PMID: 39433124 [https://pubmed.ncbi.nlm.nih.gov/39433124/] Laporte-Amargos J, Carmona-Torre F, Huguet M, et al. Efficacy of extended infusion of β-lactam antibiotics for the treatment of febrile neutropenia in haematologic patients (BEATLE): a randomized, multicentre, open-label, superiority clinical trial. Clin Microbiol Infect 2024;S1198-743X(24)00488-9.