Preiksaitis J K, Desai S, Vaudry W, Roberts S, Akabutu J, Grundy P, Wilson B, Boshkov L, Hannon J, Joffres M
Department of Medicine, University of Alberta, Edmonton, Canada.
Transfusion. 1997 Sep;37(9):941-6. doi: 10.1046/j.1537-2995.1997.37997454022.x.
The use of cytomegalovirus (CMV)-"safe" blood has been recommended for CMV seronegative patients with newly diagnosed malignant disease for whom bone marrow transplantation is a future option.
To evaluate this policy, 76 CMV-seronegative children with lymphoreticular malignancies or solid tumors were randomly assigned to receive either blood components that were not screened for CMV antibody or CMV-seronegative red cell (RBC) and platelet units. Subjects were followed for evidence of CMV infection by the use of enzyme-linked immunosorbent assays and virus isolation. Follow-up continued long after the blood transfusions to determine the risk of community-acquired CMV infection.
No cases of transfusion-acquired CMV infection were documented. The prevalence of CMV IgG and IgM antibody in blood donors was 40.5 and 0.9 percent, respectively. Patients assigned to receive standard blood components and CMV-negative components were given a median (range) of 7 (1-30) and 9 (1-38) RBC units and 11 (0-123) and 14 (0-71) platelet units, respectively. The risk of transfusion-acquired CMV infection is estimated to be less than 1 in 698 donor exposures. Two patients developed asymptomatic community-acquired CMV infection, for an incidence of 1.7 percent per patient-year of follow-up.
The risk of transfusion-acquired CMV infection in this population is low, largely because of the patients' low level of exposure to seropositive blood and the use of relatively white cell-reduced components for purposes other than CMV prevention. Such children at this center therefore continue to receive standard blood components. Strategies to prevent CMV seroconversion in these children should include parental education to minimize the risk of community-acquired infection.
对于新诊断出患有恶性疾病且未来可能进行骨髓移植的巨细胞病毒（CMV）血清学阴性患者，推荐使用CMV“安全”血液。
为评估该政策，76名患有淋巴网状恶性肿瘤或实体瘤的CMV血清学阴性儿童被随机分配接受未筛查CMV抗体的血液成分或CMV血清学阴性的红细胞（RBC）和血小板单位。通过酶联免疫吸附测定和病毒分离对受试者进行随访，以寻找CMV感染的证据。输血后很长一段时间内都持续进行随访，以确定社区获得性CMV感染的风险。
未记录到输血获得性CMV感染病例。献血者中CMV IgG和IgM抗体的患病率分别为40.5%和0.9%。被分配接受标准血液成分和CMV阴性成分的患者分别接受了中位数（范围）为7（1 - 30）个RBC单位和9（1 - 38）个RBC单位，以及11（0 - 123）个和14（0 - 71）个血小板单位。估计输血获得性CMV感染的风险低于每698次接触献血者1例。两名患者发生了无症状的社区获得性CMV感染，随访期间每位患者每年的发病率为1.7%。
该人群中输血获得性CMV感染的风险较低，这主要是因为患者接触血清学阳性血液的水平较低，以及为非CMV预防目的使用了相对白细胞减少的成分。因此，该中心的此类儿童继续接受标准血液成分。预防这些儿童发生CMV血清转化的策略应包括对家长进行教育，以尽量降低社区获得性感染的风险。
