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Review
. 2025 Aug;25(8):e451-e462.
doi: 10.1016/S1473-3099(25)00069-6. Epub 2025 Apr 3.

Recommendations from the 10th European Conference on Infections in Leukaemia for the management of cytomegalovirus in patients after allogeneic haematopoietic cell transplantation and other T-cell-engaging therapies

Per Ljungman  1 , Sophie Alain  2 , Roy F Chemaly  3 , Hermann Einsele  4 , Federica Galaverna  5 , Hans H Hirsch  6 , Alicja Sadowska-Klasa  7 , David Navarro  8 , Jan Styczynski  9 , Rafael de la Camara  10
Affiliations
Review

Recommendations from the 10th European Conference on Infections in Leukaemia for the management of cytomegalovirus in patients after allogeneic haematopoietic cell transplantation and other T-cell-engaging therapies

Per Ljungman et al. Lancet Infect Dis. 2025 Aug.

Abstract

Cytomegalovirus (CMV) remains the most important viral pathogen in patients after allogeneic haematopoietic cell transplantation (HCT), resulting in morbidity and mortality. The European Conference on Infections in Leukaemia (ECIL) brings together experts in several fields to produce evidence-based recommendations from comprehensive literature reviews. Management of CMV has been addressed twice before; the previous guideline update from the ECIL was published in 2019. The 10th ECIL meeting in 2024 addressed new developments in CMV management after allogeneic HCT, and recommendations are presented in this Review. Management recommendations include diagnostics, such as immune monitoring, antiviral prophylaxis with letermovir, management of resistant and refractory CMV infections, and paediatric aspects of CMV management. Furthermore, the 10th ECIL introduced recommendations for two new categories: patients treated with chimeric antigen receptor T cells or treated with bispecific T-cell-engaging antibodies.

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Conflict of interest statement

Declaration of interests PL has served as a consultant and speaker for MSD, a consultant and speaker for Moderna, a speaker for Biotest, and a consultant for Anocca Pharmaceuticals and Takeda on CMV. RFC serves as a consultant, speaker, or scientific advisor related to CMV for Merck (USA), MSD (Europe), Takeda, Oxford Immunotec, Moderna, and Eurofins-Viracor. He received research grants related to CMV paid to his institution from Merck, Takeda, Oxford Immunotec, and Eurofins Viracor. JS served as a speaker, and a member of an advisory board for Merck (USA) and MSD (Europe). DN reports grants from Pfizer, Roche Diagnostics, BioMerieux, and Abbott Diagnostic and consulting fees and honoraria from Pfizer, Roche Diagnostics, BioMerieux, Gilead, Takeda, and Abbott Diagnostic. HHH has received an honorarium for consulting for Allovir, AstraZeneca, Roche, Moderna, and VeraTx and as speaker for Eurofins-Viracor, Takeda, Biotest, VeraTx, and Gilead. AS-K has served as a speaker for Astellas. RdlC has served as a consultant and speaker for MSD and Moderna for CMV. SA reports research grants to her institution from Takeda, MSD, Hologic, and Elitech. FG and HE declare no competing interests.

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