Transfusion of leukoreduced cellular blood components from cytomegalovirus-unscreened donors in allogeneic hematopoietic transplant recipients: analysis of 72 recipients

Abstract

Summary:Leukoreduction of blood components has been considered a safe alternative to screening donors for CMV. The objective of this study is to analyze the effectiveness of bedside leukoreduction in preventing CMV transmission. We retrospectively studied 72 transplant recipients and donors who were CMV-seronegative pairs. All patients were transfused with CMV-unscreened cellular blood products leukoreduced at the bedside using leukoreduction filters. Quality control measures performed monthly in our leukoreduced blood components consistently demonstrated that at least 95% of the units sampled meet the leukoreduction criterion established by the American Association of Blood Banks standards. The CMV status of the recipients and donors was determined before transplantation by the latex agglutination assay. Recipients were observed for at least 100 days after transplantation. CMV cultures of urine, buffy coat, bone marrow, and bronchial washings were done weekly when indicated. CMV antigenemia testing was performed twice weekly: 11 transplant recipients seroconverted after transplantation. One patient was positive for CMV antigenemia 4 months after transplantation, but did not have CMV infection. Two of 61 patients who were not seroconverted were CMV antigenemia positive and did not have CMV infection: leukoreduction of cellular blood products is an efficient method of preventing CMV infection.

Direct assessment of cytomegalovirus transfusion‐transmitted risks after universal leukoreduction

“…It is also interesting to note that Subject 2 had clinical symptoms suspicious for CMV infection and a positive CMV NAT, but did not have a sustained seroconversion. A similar phenomenon has been reported previously in patient populations receiving chemotherapy; the antibody titer became nondetectable possibly due to immunosuppresion 40 . In addition, there was a report of detection of cellular immunity against CMV without the detection of CMV antibody 41 .…”

Prevalence of cytomegalovirus antibodies in blood donars at the National Blood Transfusion Centre, Nairobi

“…Infection may result in hepatitis, retinitis, and multisystem failure (8)(9)(10)(11). Susceptible patients should therefore receive CMV safe blood products, which should either be CMV seronegative or leucoreduced (12)(13)(14).…”

Humanes Cytomegalievirus (HCMV)

“…der Applikation von seronegativem Blut sind widersprüchlich. Einerseits wird beschrieben, dass die Leukozytendepletion der Verwendung HCMV-seronegativer, nicht leukozytenreduzierter Blutkomponenten äquivalent ist [55,62,63,116,119,[139][140][141][142][143][144][145][146]. Neue Studienergebnisse belegen, dass frisch serokonvertierte Spender die höchsten Viruskonzentrationen im Verlauf einer HCMV-Infektion haben.…”