Vamvakas Eleftherios C
Canadian Blood Services, Ottawa, Canada.
Transfus Med Rev. 2005 Jul;19(3):181-99. doi: 10.1016/j.tmrv.2005.02.002.
The question whether the use of cytomegalovirus (CMV)-seronegative versus white blood cell (WBC)-reduced blood components is equally efficacious in preventing transfusion-acquired CMV infection remains unresolved. A total of 829 recipients of CMV-seronegative components were followed in 11 studies, and a total of 878 recipients of WBC-reduced components were followed in 12 studies. Twelve (1.45%) of 829 recipients of CMV-seronegative components and 24 (2.73%) of 878 recipients of WBC-reduced components developed CMV infection in these studies. Among bone marrow transplant (BMT) recipients, the risk of CMV infection was, respectively, 1.63% (11/674) and 3.01% (21/697). Four of 7 controlled studies of CMV-seronegative components and 1 of 3 controlled studies of WBC-reduced components indicated benefit from these special components compared with CMV-unscreened/non-WBC-reduced components. One of 3 controlled studies indicated benefit from CMV-seronegative components, as compared with WBC-reduced components. Across a subset of studies whose results were integrated in a meta-analysis, CMV-seronegative or WBC-reduced components were virtually equivalent to each other when they were compared with CMV-unscreened/non-WBC-reduced components. CMV-seronegative components were associated with a 93.1% reduction in the risk of CMV infection; WBC-reduced components were associated with a 92.3% reduction in risk (summary odds ratio [OR] = 0.069; 95% confidence interval [CI], 0.037-0.128; P < .05; and summary OR = 0.077; 95% CI, 0.031-0.190; P < .05, respectively). However, across 3 studies that compared CMV-seronegative and WBC-reduced components to each other, CMV-seronegative components were associated with a 58% reduction in risk (summary OR = 0.42; 95% CI, 0.22-0.79; P < .05). Thus, a meta-analysis of the available controlled studies indicates that CMV-seronegative blood components are more efficacious than WBC-reduced blood components in preventing transfusion-acquired CMV infection.
使用巨细胞病毒（CMV）血清阴性的血液成分与白细胞（WBC）减少的血液成分在预防输血获得性CMV感染方面是否同样有效，这一问题仍未得到解决。在11项研究中，共对829名接受CMV血清阴性成分输血的受者进行了随访，在12项研究中，共对878名接受WBC减少成分输血的受者进行了随访。在这些研究中，829名接受CMV血清阴性成分输血的受者中有12名（1.45%）发生了CMV感染，878名接受WBC减少成分输血的受者中有24名（2.73%）发生了CMV感染。在骨髓移植（BMT）受者中，CMV感染的风险分别为1.63%（11/674）和3.01%（21/697）。在7项关于CMV血清阴性成分的对照研究中，有4项研究表明，与未筛查CMV/未减少WBC的成分相比，这些特殊成分具有益处。在3项关于WBC减少成分的对照研究中，有1项研究表明具有益处。在3项对照研究中，有1项研究表明，与WBC减少成分相比，CMV血清阴性成分具有益处。在一组其结果被纳入荟萃分析的研究中，当将CMV血清阴性或WBC减少的成分与未筛查CMV/未减少WBC的成分进行比较时，它们实际上是等效的。CMV血清阴性成分使CMV感染风险降低了93.1%；WBC减少成分使风险降低了92.3%（汇总比值比[OR]=0.069；95%置信区间[CI]，0.037 - 0.128；P <.05；汇总OR = 0.077；95% CI，0.031 - 0.190；P <.05）。然而，在3项将CMV血清阴性成分和WBC减少成分相互比较的研究中，CMV血清阴性成分使风险降低了58%（汇总OR = 0.42；95% CI，0.22 - 0.79；P <.05）。因此，对现有对照研究的荟萃分析表明，在预防输血获得性CMV感染方面，CMV血清阴性的血液成分比WBC减少的血液成分更有效。
