%0 Journal Article %J Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation// Biol Blood Marrow Transplant %D 2012 %T Efficiency and risk factors for CMV transmission in seronegative hematopoietic stem cell recipients. %A Pergam, Steven A %A Xie, Hu %A Sandhu, Ravinder %A Pollack, Margaret %A Smith, Jeremy %A Stevens-Ayers, Terry %A Ilieva, Valeria %A Kimball, Louise E %A Huang, Meei-Li %A Hayes, Tracy S %A Corey, Lawrence %A Boeckh, Michael J %K *Antibodies, Viral/im [Immunology] %K *Bone Marrow Transplantation/ae [Adverse Effects] %K *Cytomegalovirus Infections/tm [Transmission] %K *Cytomegalovirus/im [Immunology] %K *Hematopoietic Stem Cell Transplantation/ae [Adverse Effects] %K Adult %K Antibodies, Viral/bl [Blood] %K Cytomegalovirus Infections/bl [Blood] %K Cytomegalovirus Infections/ep [Epidemiology] %K Cytomegalovirus Infections/im [Immunology] %K Female %K Humans %K Incidence %K Male %K Middle Aged %K Proportional Hazards Models %K Retrospective Studies %K Risk Factors %K Tissue Donors %K Transplantation, Homologous %K United States/ep [Epidemiology] %X Cytomegalovirus (CMV) transmission via stem cells or marrow in CMV donor seropositive/recipient seronegative (D+/R-) hematopoietic cell transplantation (HCT) is surprisingly inefficient, and factors associated with transmission in these high-risk HCT recipients are unknown. In a retrospective cohort of D+/R- HCT recipients, cumulative incidence curve estimates were used to determine posttransplantation rates of CMV and multivariable Cox proportional models to assess risk factors associated with transmission. A total of 447 patients from 1995 to 2007 were eligible for enrollment. Overall, 85 of 447 (19.0%) acquired CMV at a median of 49 days (IQR 41-60) posttransplantation. CMV disease before day 100 occurred in 6 of 447 (1.3%) patients and in 7 of 447 (1.6%) after day 100. The donor graft, specifically the total nucleated cell count (adjusted hazard ratio [HR] 2.7; 95% confidence interval [CI], 1.4-4.7, P = .0002), was the only factor associated with CMV transmission in multivariable analyses. Notably, the source stem cells (marrow versus peripheral blood stem cell [PBSC]), screening method, and graft-versus-host disease (GVHD) were not associated with transmission. Thus, a highly cellular graft was the only identifiable risk factor associated with CMV transmission, suggesting that viral genomic content of the donor graft determines transmission efficiency in D+/R- HCT recipients.Copyright © 2012 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved. %B Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation// Biol Blood Marrow Transplant %C United States %V 18 %P 1391 - 400 %8 2012// %@ 1523-6536 %G eng %N 9 %< http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=medl&NEWS=N&AN=22387334