Prevention of Transfusion-Acquired Cytomegalovirus Infection in Infants by Blood Filtration to Remove Leucocytes

Gilbert, G. L.; Hudson, Irene L.; Hayes, Kathleen; James, J.

doi:10.1016/s0140-6736(89)92330-1

Cited by 307 publications

(152 citation statements)

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“…Use of CMV seronegative blood products and routine deleukocytation has reduced the risk of CMV transmission by transfusion. 7 Thus, the risk of CMV transmission in CMV seronegative recipients receiving a CMV seropositive graft and therefore CMV-associated disease is very low. The infectious risk can be restricted to the viral load of the transplant.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 The transmission of CMV infection from seropositive blood products can be neglected since white blood cell filtration is routinely used. 3,7,8 Prophylaxis with ganciclovir (GCV) given to all seropositive patients leads to a decreased incidence and severity of CMV infection but this therapeutic option is associated with neutropenia and in consequence bacterial and fungal infections are more frequent in these patients. 9,10 Pre-emptive therapy based on screening for culture-proven CMV infection, CMV antigenemia by leukocyte expression of pp65 matrix protein, or CMV-DNA by PCR testing reduces the incidence of CMV diseases.…”

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confidence: 99%

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Reduced risk of persisting cytomegalovirus pp65 antigenemia and cytomegalovirus interstitial pneumonia following allogeneic PBSCT

Trenschel

Roß²,

Hüsing

et al. 2000

Bone Marrow Transplant

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Summary:In order to evaluate the risk of cytomegalovirus (CMV) associated disease after allogeneic stem cell transplantation (SCT), 158 consecutive patients at risk for infection were analyzed. BMT was performed in 101 patients and peripheral blood stem cell transplantation (PBSCT) in 57 patients. CMV antigenemia was found in 57 cases (56%) after BMT and 27 cases (47%) after PBSCT, respectively. CMV antigenemia resistant to a 14-day course of GCV was found in 26 patients (26%) after BMT but in only four patients (7%) after PBSCT (P Ͻ 0.01). Eighteen patients (11%) developed CMV disease, 14 post BMT and four post PBSCT. Lethal CMVrelated interstitial pneumonia (CMV-IP) occurred in 13 cases of whom 12 patients were bone marrow recipients (P = 0.04). The subgroup of seronegative patients with a CMV seropositive donor had a significantly lower risk of developing CMV antigenemia, GCV-resistant CMV antigenemia (P Ͻ 0.01) and CMV-related disease (P = 0.01). In conclusion, the incidence of persistent CMV antigenemia and CMV-IP was significantly reduced when allogeneic transplantation was performed with peripheral blood stem cells instead of bone marrow. These findings suggest that our previous in vitro data on improved immune reconstitution after allogeneic PBSCT as compared to allogeneic BMT have clinical relevance. Bone Marrow Transplantation (2000) 25, 665-672. Keywords: CMV infection; CMV interstitial pneumonia; pp65 antigenemia; BMT; PBSCT; immune reconstitution Cytomegalovirus (CMV)-related disease is one of the most frequent infectious complications after allogeneic stem cell transplantation (SCT). 1,2 Despite new therapeutic options, symptomatic CMV infection still has a high mortality rate, especially when interstitial pneumonia (CMV-IP) develops. 3,4 Well-known risk factors of CMV infection and related diseases are acute graft-versus-host disease (aGVHD) and positive serology for CMV of recipient and/or donor before transplantation. 1,3 There is still controversy about an increased incidence of CMV infection or CMV-related disease after allogeneic bone marrow transplantation (BMT) with a matched unrelated donor (MUD) instead of an identical sibling donor (ISD). 5,6 The transmission of CMV infection from seropositive blood products can be neglected since white blood cell filtration is routinely used. 3,7,8 Prophylaxis with ganciclovir (GCV) given to all seropositive patients leads to a decreased incidence and severity of CMV infection but this therapeutic option is associated with neutropenia and in consequence bacterial and fungal infections are more frequent in these patients. 9,10 Pre-emptive therapy based on screening for culture-proven CMV infection, CMV antigenemia by leukocyte expression of pp65 matrix protein, or CMV-DNA by PCR testing reduces the incidence of CMV diseases. 11-19 Viral load appears to be proportional to CMV antigenemia in the systemic circulation. Thus, CMV antigenemia-triggered preemptive treatment lowers the duration and side-effects of antiviral therapy after SCT which is considered ...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Reduced risk of persisting cytomegalovirus pp65 antigenemia and cytomegalovirus interstitial pneumonia following allogeneic PBSCT

Trenschel

Roß²,

Hüsing

et al. 2000

Bone Marrow Transplant

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“…The use of leukodepleted cellular blood products eliminat ed the risk of transfusion-acquired CMV infection. Previous studies have shown that the possibility of CMV infection through transfusion is very low when using filters 22) .…”

Section: Resultsmentioning

confidence: 98%

Breast Milk-Transmitted Cytomegalovirus Infection in Preterm Infants

Gang

Chang

2018

Neonatal Med

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Purpose: The purpose of this study is to describe the rate of cytomegalovirus (CMV) virolactia, and the prevalence of breast milk (BM)-transmitted postnatal CMV infection among premature infants after freeze-thawing (FT) and Holder pasteurization (HP) of breast milk. Methods: This is a single-center, retrospective study of 312 infants born at less than 32 weeks of gestation, or with a birth weight less than 1,500 g from January 2013 to June 2017. All infants were screened for CMV-specific immunoglobulin (Ig) G and IgM at birth. Initial CMV specific polymerase chain reaction (PCR) and CMV culture were performed on mothers' BM and babies' urine within the first 21 days of life. FT and HP of BM was used to prevent the transmission of CMV. For the surveillance of postnatal CMV infection, CMV culture and CMV specific PCR of urine from babies were repeated one to two months after the initial screening. Screening for viremia and viruria was performed if postnatal CMV infection was suspected. Results: Among 178 BM samples obtained from mothers of CMV-IgG-seropositive infants, 80 (44.9%) were CMV PCR positive. CMV deoxyribonucleic acid (DNA) was detected in five of the 22 BM samples (22.7%) obtained from the mothers of CMV-IgG seronegative infants. When CMV DNA load in BM was measured before and after HP, various results were shown. Sixty-three infants out of 232 (27.2%) were evaluated for postnatal CMV infection and four infants out of 63 (6.3%) were infected. Conclusion: Interventions to prevent BM-transmitted CMV infection can reduce the chance of postnatal CMV infection, but not completely eliminate it.

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“…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.…”

Section: Möglichkeiten Zur Abtrennung Und Inaktivierung Von Infektionunclassified

Humanes Cytomegalievirus (HCMV)

2017

Bundesgesundheitsbl

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Prevention of Transfusion-Acquired Cytomegalovirus Infection in Infants by Blood Filtration to Remove Leucocytes

Cited by 307 publications

References 10 publications

Reduced risk of persisting cytomegalovirus pp65 antigenemia and cytomegalovirus interstitial pneumonia following allogeneic PBSCT

Reduced risk of persisting cytomegalovirus pp65 antigenemia and cytomegalovirus interstitial pneumonia following allogeneic PBSCT

Breast Milk-Transmitted Cytomegalovirus Infection in Preterm Infants

Humanes Cytomegalievirus (HCMV)

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