Letermovir for Cytomegalovirus prophylaxis in pediatric hematopoietic stem cell transplantation

BACKGROUND

Letermovir (LTV), an antiviral with exclusive activity against Cytomegalovirus (CMV), is approved for prophylaxis of CMV infection and disease in adult hematopoietic cell transplant (HCT) patients. The use of LTV in the pediatric HCT population is off-label, and has limited literature to support its use.

PROCEDURE

This was a single-center, retrospective, matched (1:1 LTV:non-LTV) cohort study of allogeneic HCT recipients transplanted at Children's Hospital Colorado from 2015 to 2022. The primary endpoint was clinically significant CMV DNAemia (defined as a CMV viral load >1000 copies/mL or any CMV DNAemia leading to preemptive treatment) through 6 months post transplant. Secondary outcomes included time to clinically significant CMV DNAemia, drug adverse effects, and dose adjustments of concomitant cyclosporine and voriconazole (known drug interactions).

RESULTS

We compared 41 patients who received LTV prophylaxis to 41 patients who received no CMV prophylaxis. There was less clinically significant CMV DNAemia through D+180 in the LTV group (9.8% vs. 17.0%, p = .33). Overall, LTV was well tolerated, and 87.8% of patients experienced no adverse effects related to the drug. There was no observed pattern in LTV effect on cyclosporine serum concentrations, but LTV was associated with decreased voriconazole trough levels.

CONCLUSIONS

In this retrospective study, the use of LTV prophylaxis in pediatric stem cell patients was associated with reduced clinically significant CMV DNAemia through D+180.

Curcumin: a novel non-steroidal contraceptive with antimicrobial properties

Women face unique pathologies and challenges related to the female genital tract (FGT), including vaginal infections and gynecologic cancers. Vaginal infections faced by women include bacterial vaginosis (BV), vulvovaginal candidiasis (VC), and sexually transmitted infections (STIs). Curcumin, a component of the dietary spice turmeric, has immense biological properties, including antioxidant, anti-inflammatory/immunomodulatory, and anticancer effects. It has no side effects and is well-tolerated, making it an ideal treatment modality highly desired by women. Recently, our laboratory showed, for the first time ever, that curcumin exhibits a spermicidal and broad-spectrum microbicidal activity against several species of bacteria and yeast involved in vaginal infections. Thus, it could provide a novel, non-steroidal contraceptive having both spermicidal and microbicidal properties and can be panacea in women for treatment of several FGT pathologies, including gynecologic cancers.

Polycystic ovary syndrome: current status and future perspective

Polycystic ovary syndrome (PCOS) is a widespread reproductive disorder that encompasses many associated health conditions and has an impact on various metabolic processes. PCOS is depicted by hyperandrogenism, polycystic ovaries, and anovulation. It increases the risk of insulin resistance (IR), type 2 diabetes, obesity, and cardiovascular disease. The etiology of the disease remains unclear, and the subjective phenotype makes a united diagnosis difficult among physicians. It seems to be a familial genetic syndrome caused by a combination of environmental and genetic factors. It can be linked with metabolic disorders in first-degree family members. PCOS is the cause of up to 30% of infertility in couples seeking treatment. Currently, there is no cure for PCOS. Despite the growing incidence of this syndrome, limited research has been done that encompasses the entirety of PCOS spectrum. In this review, the current status and possible future perspective will be discussed.