Leflunomide: a small step forward in meeting the urgent need for treatment of drug-resistant cytomegalovirus infection.

摘要

There is an urgent, and as yet unmet, need for therapy for cytomegalovirus (CMV) infection resistant to ganciclovir in solid organ and bone marrow transplantation. Since the recognition that CMV can emerge resistant to ganciclovir in solid organ or bone marrow transplant recipients, the approach to management has been difficult (1,2). This need is because although rare, ganciclovir resistance in CMV infections in solid organ and bone marrow transplant recipients seems to be increasing slightly. In our own transplant programs, we have seen several cases in the past few years, whereas in the prior 15- to 18-year interval, during which ganciclovir was licensed and used clinically, we had the occurrence of one case of clinically resistant CMV disease in a bone marrow transplant recipient.