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Evolution of human cytomegalovirus‐seronegative donor/‐seropositive recipient high‐risk combination frequency in allogeneic hematopoietic stem cell transplantations at Institute of Hematology and Blood Transfusion during 1995–2014
Author(s) -
Nemeckova S.,
Sroller V.,
StastnaMarkova M.
Publication year - 2016
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12508
Subject(s) - medicine , serostatus , human cytomegalovirus , hematopoietic stem cell transplantation , transplantation , hematology , cohort , cytomegalovirus , immunology , stem cell , incidence (geometry) , hematopoietic stem cell , odds ratio , haematopoiesis , viral disease , viral load , herpesviridae , virus , biology , physics , optics , genetics
Background Human cytomegalovirus ( HCMV ) establishes lifelong latent infection that can result in severe life‐threatening disease in immunosuppressed patients after hematopoietic stem cell transplantation ( HSCT ). An HCMV ‐seropositive transplant recipient who receives a graft from a seronegative donor (R+/D−) is at high risk of recurrent HCMV reactivation. Methods To assess the incidence of R+/D− combination, we retrospectively evaluated HCMV ‐seronegative donors for 746 allogeneic HSCT treatments carried out at our center during 1995–2014. In our cohort, 20% HCMV ‐seronegative HSCT recipients, 21% HCMV ‐seronegative related graft donors, and 52% HCMV ‐seronegative unrelated graft donors were included. Results Analyses of the HCMV serostatus of hematopoietic stem cell donors during 2 consecutive calendar periods (1995–2005 and 2006–2014) showed a significant increase in the proportion of seronegative donors (odds ratio [ OR ] = 1.947). In addition, the number of HSCT treatments using an unrelated donor increased ( OR = 2.376). Finally, the use of grafts from countries with a very low HCMV prevalence increased. Conclusion This increase in HCMV seronegativity in unrelated donors and the increased proportion of unrelated donors were responsible for the increased occurrence of the high‐risk combination R+/D− ( OR = 1.680). If the reduction in the rate of HCMV ‐seropositive graft donors continues, an increased frequency of HCMV reactivation events in our transplant recipients can be expected, because of the increasing occurrence of the high‐risk R+/D− combination.