AUTHOR=Kamar Nassim , Kaminski Hannah , Masset Christophe , Castagné Claire , Tournaire Guilhem , Bourge Xavier , Bensimon Lionel , Naja Moustafa , Degroote Stéphanie , Durand-Zaleski Isabelle , Legendre Christophe 

TITLE=Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational Study

JOURNAL=Transplant International

VOLUME=Volume 38 - 2025

YEAR=2025

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2025.14342

DOI=10.3389/ti.2025.14342

ISSN=1432-2277

ABSTRACT=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 six 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+/Rsubgroup 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.