Use of Leucocyte‐poor Blood Components to Prevent Primary Cytomegalovirus (Cmv) Infection in Patients With Acute Leukaemia

Murphy, M. F.; Grint, P.; Hardiman, Annarella; Lister, T. A.; Waters, A. H.

doi:10.1111/j.1365-2141.1988.tb02473.x

Cited by 87 publications

(27 citation statements)

References 4 publications

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“…Consequently, with the appropriate quality control measures in place, our results will likely be applicable to other institutions and will allow this approach to be used for other populations at high risk for transfusion-associated infections. 10,12 …”

Section: Discussionmentioning

confidence: 99%

Transfusion support using filtered unscreened blood products for cytomegalovirus-negative allogeneic marrow transplant recipients

Narvios

Przepiorka

Tarrand

et al. 1998

Bone Marrow Transplant

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Summary:It has been suggested that leukoreduced unscreened blood products can be used as an alternative to components from cytomegalovirus (CMV)-seronegative donors in order to prevent transmission of CMV from transfusions for CMV-seronegative marrow transplant recipients with CMV-seronegative donors, but confirmatory data are lacking. A retrospective chart review was undertaken for patients undergoing allogeneic transplantation over a 4-year period during which blood products were filtered for CMV-seronegative patients with CMV-seronegative donors when CMVseronegative components were not available. Forty-five CMV-seronegative patient-donor pairs were identified. Only one patient developed CMV disease (pneumonia) and no other patients developed an infection. In this group of patients, the rate of CMV infection was 2.7% (95% CI, 0-8%) by life-table analysis. We conclude that filtered unscreened blood products as partial transfusion support for CMV-seronegative marrow transplant recipients were associated with a low incidence of CMV infection, justifying further evaluation of filtered blood products as total transfusion support for this patient population. However, since CMV infections still occur, continued surveillance by periodic culture or other techniques is warranted. Keywords: cytomegalovirus infections; filtered blood components; bone marrow transplantation Meyers et al 1 reported that 28% of cytomegalovirus (CMV)-seronegative marrow transplant recipients with CMV-seronegative donors developed CMV infections, and these were attributed to transmission of virus by leukocytes in blood components used for transfusions. Although use of blood products solely from CMV-seronegative donors was associated with a reduction in CMV infection to approximately 3% in CMV-seronegative transplant patients, 2,3 the availability of such blood products is limited by the high incidence of CMV infection in the general population. Leukoreduction by filtration has emerged as an alternative means for providing unscreened blood compoCorrespondence: Dr B Lichtiger, The

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Section: Discussionmentioning

confidence: 99%

Transfusion support using filtered unscreened blood products for cytomegalovirus-negative allogeneic marrow transplant recipients

Narvios

Przepiorka

Tarrand

et al. 1998

Bone Marrow Transplant

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“…WBC in particular are important immunogenic agenst [1, 2, 3] and may cause posttransfusional CMV infections, CMV reactivation [4, 5, 6], and HLA antibody formation leading to platelet refractoriness [7, 8, 9]. A great deal of work has therefore been done to prevent transfusion recipients from receiving donor leukocytes [10, 11, 12, 13, 14, 15, 16]. This leukoreduction is usually done by filtration [17].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Platelet Apheresis Technique for the Preparation of Leukocyte-Reduced Platelet Concentrates

Zingsem¹,

Glaser²,

Weisbach³

et al. 1998

Vox Sanguinis

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Objectives: Reduction of the white blood cell (WBC) contamination in platelet concentrates (PC) protects patients from the immunological and infectious side effects of platelet transfusion caused by WBC. This can be done either by filtration of the PC or by improved apheresis techniques that yield WBC-poor preparations. Methods: To evaluate an improved technique for platelet collection, we carried out 201 separations in 89 healthy cytapheresis donors using the new COBE Spectra leukoreduction system (LRS) and compared the results with those of standard dual-needle separations obtained with the same cell separator. Results: A small but statistically significant difference was found in platelet collection efficiency in comparison with the standard non-LRS software procedures (LRS: 52.6 vs. 56.3% for the reference). However, median WBC contamination was only 0.01 × 10⁶ WBC per LRS product. This significant (p < 0.0005) improvement corresponds to a 10-fold reduction of WBC as compared with the standard dual-needle technique. Conclusions: The COBE Spectra LRS system produced PCs with a platelet collection efficiency nearly equal to previous techniques and with a residual WBC content satisfying even the most stringent criteria for WBC-depleted blood components. As this purity is achieved without important platelet loss, conventional fiber filtration no longer seems necessary in this kind of PC.

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“…LR has been shown to be an effective method in this patient population in the prevention of TT-CMV infection. 36,38 Although head-to-head studies comparing CMV-seronegative versus LR-only versus LR/CMV-seronegative blood products in this patient population are lacking, it is unlikely that these patients would be at a higher risk of TT-CMV infection than HSCT patients. Therefore, in light of the evidence discussed above for HSCT patients, an LR-only approach for transfusion in patients with hematologic malignancies may be safely employed.…”

Section: Hematologic Malignancy Patientsmentioning

confidence: 99%

“…As CMV infection is restricted to small numbers of WBCs during latent infection, the removal of these WBCs significantly decreases the risk of TT-CMV infection. [36][37][38] Leukofiltration using filters composed of cellulose acetate, polyurethane, polycarbonate, or polyester is the most common method for leukodepletion of whole blood-derived components. 39 The pore size of these filters is designed to impede the passage of leukocytes, but allow the passage of erythrocytes and platelets.…”

Section: Strategies For the Reduction Of Tt-cmv Infectionmentioning

confidence: 99%

Current strategies and future directions for the prevention of transfusion-transmitted cytomegalovirus

Harmon¹,

Cooling²

2017

IJCTM

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Cytomegalovirus (CMV) is a pervasive DNA virus that infects a significant portion of individuals worldwide, and may be transmitted through the transfusion of blood products. Although CMV infection is of little consequence in immunocompetent individuals, patients with an impaired immune system are at risk of significant morbidity and mortality. Unlike other blood-borne infectious agents, it is impractical to defer all CMV-positive individuals from blood donation as this would exclude a substantial number of otherwise eligible donors. Other methods such as transfusion of CMV-seronegative and leukoreduced blood products must be employed to prevent the transmission of CMV to at-risk patients. In this study, the widespread use of current strategies for the prevention of transfusion-transmitted CMV (TT-CMV) infection and the evidence to support these methods in various at-risk groups were reviewed. In addition, emerging pathogen inactivation technologies that have the potential to eliminate TT-CMV were also discussed.

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Use of Leucocyte‐poor Blood Components to Prevent Primary Cytomegalovirus (Cmv) Infection in Patients With Acute Leukaemia

Cited by 87 publications

References 4 publications

Transfusion support using filtered unscreened blood products for cytomegalovirus-negative allogeneic marrow transplant recipients

Transfusion support using filtered unscreened blood products for cytomegalovirus-negative allogeneic marrow transplant recipients

Evaluation of a Platelet Apheresis Technique for the Preparation of Leukocyte-Reduced Platelet Concentrates

Current strategies and future directions for the prevention of transfusion-transmitted cytomegalovirus

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