In an attempt to reduce infection related morbidity during the period of neutropenia post allo-PBSCT, patients with ABO compatible PBSC donors at our center receive 2 infusions of G-CSF mobilized donor granulocytes on d+3 and +6 or d+5 and +7. However, granulocytes are thought to be a major source of exogenous CMV following allogeneic transplantation. Therefore, we sought to analyze the effects of these granulocytes infusions on CMV infection post allo-PBSCT.235 patients underwent allo-PBSCT between Sept 94 and April 2000.101 patients received prophylactic granulocyte infusions.Surveillance for CMV viremia consisted of every other week shell vial and routine CMV cultures of blood performed on patients from neutrophil engraftment to day +150.19/47 (40%) of recipients receiving granulocyte infusions from seropositive donors (cohort 1 ) developed CMV viremia at a median 36 days post allo-PBSCT in comparison to 12/54 (22%) of recipients receiving granulocytes from seronegative donors (cohort 2);Odds Ratio 2.3(95% C.I 1.00-5.62). However, this difference in viremia was accounted for by the higher number of seropositive recipients in cohort 1 vs cohort 2; 32/46(70%) vs 12/54 (36%). A detailed analysis of incidence of CMV viremia based on donor-recipient serology in patients receiving granulocytes (n=l 01 ) and not receiving granulocytes (n= 134) is presented in table below. There was no statistically significant differences in the rates of CMV viremia in the various groups studied.CONCLUSION:Prophylactic granulocyte infusions following allo-PBSCT do not increase the risk of CMV viremia. Donor Recipient serology serology Viremia Odds ratio/ p value Granulocytes No Granulocytes 95% C.I + + 13/32(41%) 29/54(53%) 0.59(0.24-1.43) 0.24 + - 5/15(30%) 8/27(30%) 1.19(0.31-4.6) 0.80 + 10/19(53%) 8/18(44%) 1.39(0.38-5.07) 0.62 1/34(3%) 1/27(4%) 0.79(0.047-13.2) 0.87.
|Issue number||11 PART I|
|State||Published - Dec 1 2000|