title: Evolution of human cytomegalovirus-seronegative donor/-seropositive recipient high-risk combination frequency in allogeneic hematopoietic stem cell transplantations at Institute of Hematology and Blood Transfusion during 1995-2014.
abstract: BACKGROUND
  Human cytomegalovirus (HCMV) establishes lifelong latent infection that can result in severe life-threatening disease in immunosuppressed patients after hematopoietic stem cell transplantation (HSCT). An HCMV-seropositive transplant recipient who receives a graft from a seronegative donor (R+/D-) is at high risk of recurrent HCMV reactivation.
  
  
  METHODS
  To assess the incidence of R+/D- combination, we retrospectively evaluated HCMV-seronegative donors for 746 allogeneic HSCT treatments carried out at our center during 1995-2014. In our cohort, 20% HCMV-seronegative HSCT recipients, 21% HCMV-seronegative related graft donors, and 52% HCMV-seronegative unrelated graft donors were included.
  
  
  RESULTS
  Analyses of the HCMV serostatus of hematopoietic stem cell donors during 2 consecutive calendar periods (1995-2005 and 2006-2014) showed a significant increase in the proportion of seronegative donors (odds ratio [OR] = 1.947). In addition, the number of HSCT treatments using an unrelated donor increased (OR = 2.376). Finally, the use of grafts from countries with a very low HCMV prevalence increased.
  
  
  CONCLUSIONS
  This increase in HCMV seronegativity in unrelated donors and the increased proportion of unrelated donors were responsible for the increased occurrence of the high-risk combination R+/D- (OR = 1.680). If the reduction in the rate of HCMV-seropositive graft donors continues, an increased frequency of HCMV reactivation events in our transplant recipients can be expected, because of the increasing occurrence of the high-risk R+/D- combination.
authors: Department of Immunology, Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
authors: S
authors: S
authors: Nemeckova
authors: Department of Immunology, Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
authors: V
authors: V
authors: Sroller
authors: Transplantation Ward, Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
authors: M
authors: M
authors: Stastna-Markova
mesh_terms: D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000821:virology*; D018153:Czech Republic / Q000453:epidemiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D012189:Retrospective Studies; D014019:Tissue Donors; D014775:Virus Activation / Q000276:immunology*
keywords: allogeneic hematopoietic stem cell transplantation; graft donor; human cytomegalovirus; recipient; seroprevalence