CMV Serostatus of Donor-Recipient Pairs Influences the Risk of CMV Infection/Reactivation in HSCT Patients.

Bone Marrow Research Pub Date : 2012-01-01 Epub Date: 2012-11-22 DOI:10.1155/2012/375075
Emilia Jaskula, Jolanta Bochenska, Edyta Kocwin, Agnieszka Tarnowska, Andrzej Lange
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引用次数: 26

Abstract

CMV donor/recipient serostatus was analyzed in 200 patients allografted in our institution from unrelated (122 patients) donors and 78 sibling donors in the years 2002-2011 in relation to posttransplant complications. On a group basis independently of the CMV serostatus of donor-recipient pairs sibling transplantations and those from unrelated donors that matched 10/10 at allele level had a similar rate of CMV reactivation (17/78 versus 19/71, P = ns). The rate of CMV reactivation/infection was higher in patients grafted from donors accepted at the lower level of matching than 10/10 (18/38 versus 36/149, P = 0.008). The incidence of aGvHD followed frequencies of CMV reactivation in the tested groups, being 40/156 and 25/44 in patients grafted from sibling or unrelated donors that 10/10 matched and in those grafted from donors taht HLA mismatched, respectively (P = 0.001). Regarding the rate of reactivation in both groups seropositive patients receiving a transplant from seronegative donors had more frequently CMV reactivation as compared to those with another donor-recipient matching CMV serostatus constellation (22/43 versus 32/143, P = 0 < 0.001). Multivariate analysis revealed that seropositivity of recipients with concomitant seronegativity of donors plays an independent role in the CMV reactivation/infection (OR = 2.669, P = 0.037; OR = 5.322, P = 0.078; OR = 23.034, P = 0.023 for optimally matched and mismatched patients and the whole group of patients, resp.).

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供体-受体配对的巨细胞病毒血清状态影响移植患者巨细胞病毒感染/再激活的风险
我们分析了2002-2011年间200例非亲属(122例)供体和78例兄弟姐妹供体同种异体移植患者的CMV供体/受体血清状态与移植后并发症的关系。在独立于CMV血清状态的组基础上,兄弟姐妹供体-受体配对和非亲属供体在等位基因水平上匹配10/10的患者有相似的CMV再激活率(17/78 vs 19/71, P = ns)。接受低配型供体移植的患者CMV再激活/感染率高于10/10 (18/38 vs 36/149, P = 0.008)。在测试组中,aGvHD的发生率随CMV再激活的频率而变化,10/10匹配的兄弟姐妹或无亲缘关系供者移植的患者和HLA不匹配的供者移植的患者分别为40/156和25/44 (P = 0.001)。关于两组中接受血清阴性供者移植的血清阳性患者的CMV再激活率,与其他供者-受体匹配CMV血清状态星座的患者相比,CMV再激活频率更高(22/43比32/143,P = 0 < 0.001)。多因素分析显示,受体血清阳性与供体血清阴性在CMV再激活/感染中起独立作用(OR = 2.669, P = 0.037;Or = 5.322, p = 0.078;OR = 23.034, P = 0.023(最优匹配与不匹配患者及全组患者,P = 0.023)。
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