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A comparison of filtered leukocyte-reduced and cytomegalovirus (CMV)
seronegative blood products for the prevention of transfusion- associated
CMV infection after marrow transplant [see comments]
RA Bowden, SJ Slichter, M Sayers, D Weisdorf, M Cays, G Schoch, M Banaji, R Haake, K Welk and L Fisher
Division of Clinical Research, Fred Hutchinson Cancer Research Center,
Seattle, WA 98104, USA.
We performed a prospective, randomized trial in CMV seronegative marrow
recipients to determine if filtered blood products were as effective as
CMV-seronegative blood products for the prevention of transfusion-
transmitted CMV infection after marrow transplant. Before transplant, 502
patients were randomized to receive either filtered or seronegative blood
products. Patients were monitored for the development of CMV infection and
tissue-documented CMV disease between days 21 and 100 after transplant.
Infections occurring after day 21 from transplant were considered related
to the transfusion of study blood products and, thus, were considered
evaluable infections for the purpose of this trial. In the primary analysis
of evaluable infections, there were no significant differences between the
probability of CMV infection (1.3% v 2.4%, P = 1.00) or disease (0% v 2.4%,
P = 1.00) between the seronegative and filtered arms, respectively, or
probability of survival (P = .6). In a secondary analysis of all infections
occurring from day 0 to 100 post-transplant, although the infection rates
were similar, the probability of CMV disease in the filtered arm was
greater (2.4% v 0% in the seronegative arm, P = .03). However, the disease
rate was still within the prestudy clinically defined acceptable rate of
< or = 5%. We conclude that filtration is an effective alternative to
the use of seronegative blood products for prevention of transfusion-
associated CMV infection in marrow transplant patients.
Volume 86,
Issue 9,
pp. 3598-3603,
11/01/1995
Copyright © 1995 by The American Society of Hematology
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