# Refractory or resistant cytomegalovirus infections after hematopoietic stem cell transplantation: diagnosis and management

## TL;DR

This paper discusses the challenges of treating resistant cytomegalovirus infections after stem cell transplants and explores new diagnostic and treatment approaches.

## Contribution

The paper introduces combined CMV DNA PCR and CMI monitoring for better diagnosis and personalized treatment of resistant CMV infections.

## Key findings

- Resistant CMV infections remain a significant problem after HSCT despite preventive measures.
- Combining CMV DNA PCR with CMI monitoring improves diagnosis and treatment guidance.
- New antiviral drugs and immunotherapies offer potential for treating resistant CMV infections.

## Abstract

巨细胞病毒（CMV）感染是造血干细胞移植（HSCT）后最常见的机会性感染之一。尽管预防和抢先治疗可以降低CMV感染和CMV病的发生率，但仍有部分患者发展为难治性/耐药性（R/R）CMV感染，严重影响预后。对抗CMV治疗药物不耐受和发生耐药是患者发展为难治的重要原因。在CMV DNA定量PCR的基础上联合使用CMV特异性免疫介导（CMI）监测可以优化R/R CMV感染的诊断并指导个性化治疗。近年来，新型抗病毒药物、免疫治疗包括免疫球蛋白和病毒特异性T细胞治疗的探索，有望为该类患者提供更多的治疗选择。