The Use of Cytomegalovirus Cell Mediated Immunity to Optimize the Duration of Letermovir Prophylaxis in Hematopoietic Cell Transplant Recipients

NCT ID: NCT06639854

Last Updated: 2025-11-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

105 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-20

Study Completion Date

2026-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The goal of this laboratory research study is to learn if interrupting a patient's letermovir dosing based on their immune system response can help HSC transplant patients avoid post-treatment CMV infections better than taking letermovir every day without interruption.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Primary Objective

•To compare the proportion of CS-CMVi in allo-HCT recipients who had interrupted letermovir prophylaxis based on CMV CMI or extended duration of letermovir prophylaxis up to 200 days post transplantation.

Secondary Objectives

* To compare the proportion of CS-CMVi in HCT recipients who had interrupted letermovir prophylaxis based on CMV CMI or extended duration of letermovir prophylaxis at 365 days post transplantation.
* To compare the overall use of letermovir in HCT recipients in both arms.
* To compare CMV CMI in HCT recipients in both arms.
* To compare all-cause mortality and nonrelapse mortality between the 2 arms at day +200 and day +365.
* Healthcare expenditures for letermovir use and TCIP for both arms from day +100 to day +200.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Cytomegalovirus Cell Mediated Immunity Hematopoietic Cell Transplant

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Interrupted letermovir prophylaxis

Participants assigned to the investigational group, you will also receive letermovir at first, but depending on the result of the study blood tests, your dose may be paused as long as your immune system shows an immune response against CMV.

Group Type EXPERIMENTAL

Hematopoietic Cell Transplant

Intervention Type PROCEDURE

Participants choices may include to receive standard post-transplant virus prevention with letermovir or other standard drugs without being part of this study. Participants may choose to receive other investigational therapy, if available.

These alternative treatments have risks and benefits that may be the same or different than those in this research study.

Letermovir

Intervention Type DRUG

Given by PO

Standard letermovir prophylaxis

Participants assigned to the standard care group, you will receive treatment with letermovir every day to prevent CMV infection.

Group Type EXPERIMENTAL

Hematopoietic Cell Transplant

Intervention Type PROCEDURE

Participants choices may include to receive standard post-transplant virus prevention with letermovir or other standard drugs without being part of this study. Participants may choose to receive other investigational therapy, if available.

These alternative treatments have risks and benefits that may be the same or different than those in this research study.

Letermovir

Intervention Type DRUG

Given by PO

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Hematopoietic Cell Transplant

Participants choices may include to receive standard post-transplant virus prevention with letermovir or other standard drugs without being part of this study. Participants may choose to receive other investigational therapy, if available.

These alternative treatments have risks and benefits that may be the same or different than those in this research study.

Intervention Type PROCEDURE

Letermovir

Given by PO

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Allogeneic HCT recipients with positive CMV serostatus
2. On letermovir prophylaxis at day 90 post transplant (+/- 7 days)
3. At high risk for CMV reactivation after day +100:

1. Prior or active graft versus host disease requiring systemic steroids
2. Mismatch stem cell donor (includes haploidentical, mismatch unrelated donor (MMUD), match related donor with at least one mismatch at one of the three specified HLA gene loci (HLA-A, HLA-B, or HLA-DR) and cord donor recipients)
3. Received T cell depletion or anti thymoglobulin during conditioning
4. CMV reactivation prior to day 100 post transplant
5. On steroids at any dose within 2 weeks of enrollment

Exclusion Criteria

1. Patients under the age of 18
2. Patients are discharged from our institution and unwilling to come back for follow up
3. Patients are actively undergoing treatment for CS-CMVi at time of screening. Prior CS-CMVi is not an exclusion from study.
4. Patients are allergic or intolerant to letermovir or have history of letermovir resistant CMV infection.
5. Not able to procure letermovir for extended prophylaxis beyond day +100.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

M.D. Anderson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Fareed Khawaja, MBBS

Role: PRINCIPAL_INVESTIGATOR

M.D. Anderson Cancer Center

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

The University of Texas MD Anderson Cancer Center

Houston, Texas, United States

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United States

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Fareed Khawaja, MBBS

Role: CONTACT

Phone: (281) 610-0253

Email: [email protected]

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Fareed Khawaja, MBBS

Role: primary

Related Links

Access external resources that provide additional context or updates about the study.

http://www.mdanderson.org

MD Anderson Cancer Center

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

NCI-2024-08626

Identifier Type: OTHER

Identifier Source: secondary_id

2024-1144

Identifier Type: -

Identifier Source: org_study_id