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Prevention of transfusion‐transmitted cytomegalovirus infection using leukoreduced blood components in patients receiving seronegative umbilical cord blood transplantation
Author(s) -
Shigemura Tomonari,
Yanagisawa Ryu,
Komori Kazutoshi,
Morita Daisuke,
Kurata Takashi,
Tanaka Miyuki,
Sakashita Kazuo,
Nakazawa Yozo
Publication year - 2019
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.15456
Subject(s) - leukoreduction , medicine , umbilical cord blood transplantation , hematopoietic stem cell transplantation , umbilical cord , cytomegalovirus , transplantation , immunology , serostatus , blood transfusion , herpesviridae , viral disease , viral load , virus
BACKGROUND Leukoreduced blood components have been widely implemented to prevent transfusion‐transmitted cytomegalovirus (TT‐CMV) in transplantation. Recent progress in leukoreduction technology has helped reduce the risk of TT‐CMV in hematopoietic stem cell transplantation; however, its efficacy in umbilical cord blood transplantation (CBT) has not been systematically studied. STUDY DESIGN AND METHODS We retrospectively analyzed the incidence of CMV infection in patients treated with CBT who received prestorage leukoreduced, CMV‐unselected blood components between 2007 and 2017 in a single Japanese pediatric center. Patients were monitored for CMV antigenemia at least once weekly. RESULTS In total, 71 patients treated with CBT were identified. Two patients were excluded because of unknown CMV serostatus or early death after CBT. Of the remaining 69 patients, 24 developed CMV antigenemia. Among them, 3 received granulocyte transfusions (3 of 3; 100%), 2 were infants with severe combined immunodeficiency who had been infected with CMV before CBT (2 of 2; 100%), and 19 were CMV‐seropositive patients (19 of 23, 82.6%). Conversely, of the remaining 45 patients in whom CMV antigenemia did not develop, 41 were seronegative (0 of 41; 0%) and were transfused with a total of 925 leukoreduced, CMV‐unselected blood components. Among the 41 patients, 9 (22%) received in vivo T‐cell depletion with antithymocyte globulin. None of the patients in the seronegative group has subsequently shown evidence of CMV infection or developed CMV disease. CONCLUSION Using prestorage leukoreduction, no cases of CMV infection were detected in seronegative CBT patients. Our findings showed the safety of leukoreduction in preventing TT‐CMV in this patient group.