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Thiele, T; Krüger, W; Zimmermann, K; Ittermann, T; Wessel, A; Steinmetz, I; Dölken, G; Greinacher, A.
Transmission of cytomegalovirus (CMV) infection by leukoreduced blood products not tested for CMV antibodies: a single-center prospective study in high-risk patients undergoing allogeneic hematopoietic stem cell transplantation (CME).
Transfusion. 2011; 51(12):2620-2626 Doi: 10.1111/j.1537-2995.2011.03203.x
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Co-authors Med Uni Graz: Steinmetz Ivo
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Abstract:: Measures to prevent transfusion-transmitted cytomegalovirus (TT-CMV) infection after hematopoietic stem cell transplantation (HSCT) include transfusion of CMV antibody-negative blood units and/or transfusion of leukoreduced cellular blood products. We assessed the incidence of TT-CMV in CMV-seronegative patients receiving CMV-seronegative HSC transplants, who were transfused with leukoreduced cellular blood products not tested for anti-CMV. In a prospective observational study between 1999 and 2009, all HSCT patients received leukoreduced cellular blood products not tested for anti-CMV. Patients were screened for CMV serostatus and CMV-negative recipients of CMV-negative transplants were systematically monitored for TT-CMV clinically and by CMV nucleic acid testing. Anti-CMV antibodies (immunoglobulin [Ig]G and IgM) were assessed after three time intervals (Interval 1, study inclusion to Day +30 after HSCT; Interval 2, Day +30-Day +100; Interval 3, after Day +100). Among 142 patients treated with allogeneic HSCT, 23 CMV-negative donor-patient pairs were identified. These 23 patients received 1847 blood products from 3180 donors. All patients remained negative for CMV DNA and none developed CMV-associated clinical complications. This results in a risk for TT-CMV per donor exposure of 0% (95% confidence interval, 0.0%-0.12%). However, 17 of 23 patients seroconverted for anti-CMV IgG, but none for anti-CMV IgM. CMV IgG seroconverters received significantly more transfusions per week than nonconverters. The risk of TT-CMV is low in high-risk CMV(neg/neg) HSCT patients transfused with leukoreduced blood products not tested for anti-CMV. The cause of anti-CMV IgG seroconversion is most likely passive antibody transmission by blood products. © 2011 American Association of Blood Banks.
Find related publications in this database (using NLM MeSH Indexing): Antibodies, Viral - blood; Blood Component Transfusion -; Cytomegalovirus -; Cytomegalovirus Infections - blood; Cytomegalovirus Infections - prevention & control; Cytomegalovirus Infections - transmission; DNA, Viral - blood; Donor Selection - methods; Female -; Hematopoietic Stem Cell Transplantation -; Humans -; Immunoglobulin G - blood; Immunoglobulin M - blood; Leukapheresis -; Male -; Prospective Studies -; Risk Factors -; Tissue Donors -; Transplantation, Homologous -