Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational Study
The incidence of leukopenia and neutropenia associated with cytomegalovirus (CMV) prophylaxis in kidney transplant (KT) recipients is not well established. LECOCYT, a prospective observational multicenter study, aimed to investigate the clinical and economic burdens of CMV prophylaxis during the fir...
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Frontiers Media S.A.
2025-05-01
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| Series: | Transplant International |
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| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14342/full |
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| author | Nassim Kamar Hannah Kaminski Christophe Masset Claire Castagné Guilhem Tournaire Xavier Bourge Lionel Bensimon Moustafa Naja Stéphanie Degroote Isabelle Durand-Zaleski Christophe Legendre |
| author_facet | Nassim Kamar Hannah Kaminski Christophe Masset Claire Castagné Guilhem Tournaire Xavier Bourge Lionel Bensimon Moustafa Naja Stéphanie Degroote Isabelle Durand-Zaleski Christophe Legendre |
| author_sort | Nassim Kamar |
| collection | DOAJ |
| description | The incidence of leukopenia and neutropenia associated with cytomegalovirus (CMV) prophylaxis in kidney transplant (KT) recipients is not well established. LECOCYT, a prospective observational multicenter study, aimed to investigate the clinical and economic burdens of CMV prophylaxis during the first 6 months post-transplantation. Grade 3 or 4 leukopenia or neutropenia was assessed in CMV-seropositive donors/CMV-seronegative recipients (D+/R-) who received current anti-CMV prophylaxis, and in CMV-seronegative donors/CMV-seronegative recipients (D-/R-) who did not. The economic burden in D+/R- was also evaluated. The adjusted odds ratio for grade 3 or 4 leukopenia or neutropenia was 5.16 [95% confidence interval: 1.97–13.53] for D+/R- group. The median costs, excluding the KT procedure, for D+/R- subgroup patients who experienced at least one episode of severe leukopenia or neutropenia were approximately €4,500 (Q1 = €561; Q3 = €10,000). D+/R- patients with no episode incurred significantly lower costs, with a median of nearly €2,100 (Q1 = €182; Q3 = €6,500) (p = 0.02). D+/R- patients with severe leukopenia or neutropenia had a higher rate of outpatient consultations than those without episode (73.9% vs. 57.6%, p = 0.002), and a higher average number of consultations per patient (5.5 ± 4.1 vs. 4.5 ± 3.3, p = 0.042) than D+/R- patients without. Anti-CMV prophylaxis in D+/R- transplant recipients was significantly associated with a higher rate of severe leukopenia or neutropenia compared to no prophylaxis in D-/R- recipients. |
| format | Article |
| id | doaj-art-737c044fa17240ee83ebc4c66c9e57e2 |
| institution | OA Journals |
| issn | 1432-2277 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Transplant International |
| spelling | doaj-art-737c044fa17240ee83ebc4c66c9e57e22025-08-20T02:32:15ZengFrontiers Media S.A.Transplant International1432-22772025-05-013810.3389/ti.2025.1434214342Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational StudyNassim Kamar0Hannah Kaminski1Christophe Masset2Claire Castagné3Guilhem Tournaire4Xavier Bourge5Lionel Bensimon6Moustafa Naja7Stéphanie Degroote8Isabelle Durand-Zaleski9Christophe Legendre10Department of Nephrology and Organ Transplantation, Toulouse Rangueil University Hospital, Institut national de la santé et de la recherche médicale - Unité Mixte de Recherche 1291 (INSERM UMR 1291), Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), University Paul Sabatier, Toulouse, FranceDepartment of Nephrology-Transplantation-Dialysis-Apheresis, University Hospital of Bordeaux, Bordeaux, FranceDepartment of Nephrology, Institut de Transplantation Urologie-Nephrologie (ITUN), Nantes University Hospital, Nantes, FranceMSD France, Puteaux, FranceMSD France, Puteaux, FranceMSD France, Puteaux, FranceMSD France, Puteaux, FranceClinSearch, Malakoff, FranceClinSearch, Malakoff, FranceUnité de Recherche Clinique en Économie de la Santé d’Ile de France (URC-Eco), Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Est Créteil, Créteil, FranceNephrology and Renal Transplantation Department, Necker Hospital, Paris, FranceThe incidence of leukopenia and neutropenia associated with cytomegalovirus (CMV) prophylaxis in kidney transplant (KT) recipients is not well established. LECOCYT, a prospective observational multicenter study, aimed to investigate the clinical and economic burdens of CMV prophylaxis during the first 6 months post-transplantation. Grade 3 or 4 leukopenia or neutropenia was assessed in CMV-seropositive donors/CMV-seronegative recipients (D+/R-) who received current anti-CMV prophylaxis, and in CMV-seronegative donors/CMV-seronegative recipients (D-/R-) who did not. The economic burden in D+/R- was also evaluated. The adjusted odds ratio for grade 3 or 4 leukopenia or neutropenia was 5.16 [95% confidence interval: 1.97–13.53] for D+/R- group. The median costs, excluding the KT procedure, for D+/R- subgroup patients who experienced at least one episode of severe leukopenia or neutropenia were approximately €4,500 (Q1 = €561; Q3 = €10,000). D+/R- patients with no episode incurred significantly lower costs, with a median of nearly €2,100 (Q1 = €182; Q3 = €6,500) (p = 0.02). D+/R- patients with severe leukopenia or neutropenia had a higher rate of outpatient consultations than those without episode (73.9% vs. 57.6%, p = 0.002), and a higher average number of consultations per patient (5.5 ± 4.1 vs. 4.5 ± 3.3, p = 0.042) than D+/R- patients without. Anti-CMV prophylaxis in D+/R- transplant recipients was significantly associated with a higher rate of severe leukopenia or neutropenia compared to no prophylaxis in D-/R- recipients.https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14342/fullcytomegalovirus prophylaxiseconomicsganciclovirvalganciclovirkidney transplant |
| spellingShingle | Nassim Kamar Hannah Kaminski Christophe Masset Claire Castagné Guilhem Tournaire Xavier Bourge Lionel Bensimon Moustafa Naja Stéphanie Degroote Isabelle Durand-Zaleski Christophe Legendre Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational Study Transplant International cytomegalovirus prophylaxis economics ganciclovir valganciclovir kidney transplant |
| title | Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational Study |
| title_full | Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational Study |
| title_fullStr | Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational Study |
| title_full_unstemmed | Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational Study |
| title_short | Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational Study |
| title_sort | clinical and economic burden associated with anti cytomegalovirus cmv prophylaxis therapies in adult kidney transplant recipients lecocyt an observational study |
| topic | cytomegalovirus prophylaxis economics ganciclovir valganciclovir kidney transplant |
| url | https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14342/full |
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