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Blood, 1 June 2001, Vol. 97, No. 11, pp. 3640-3647
TRANSFUSION MEDICINE
The effect of leukocyte-reduction method on the amount of human
cytomegalovirus in blood products: a comparison of apheresis and
filtration methods
Larry J. Dumont,
Janos Luka,
Tania VandenBroeke,
Pamella Whitley,
Daniel R. Ambruso, and
M. Dean Elfath
From Gambro BCT, Lakewood, CO; University of Colorado
Health Sciences Center, Denver; Eastern Virginia Medical School,
Norfolk; American Red Cross, Mid-Atlantic Region, Norfolk, VA; and
Bonfils Memorial Blood Center, Denver, CO.
This study examined the effectiveness of 3 leukocyte-reduction (LR)
methods in depleting the residual level of cytomegalovirus (CMV) in
blood products measured by quantitative polymerase chain reaction
(QA-PCR). At 2 locations over 3 allergy seasons, apheresis platelets
and whole blood were collected from 52 healthy CMV seropositive subjects having an elevated titer of CMV DNA (median = 2400 genome equivalents [GE]/mL) resulting in 32 evaluable LR apheresis
platelets, 31 filtered platelets from whole blood, and 31 filtered red
blood cells (RBCs) from whole blood. Leukoreduction by apheresis and filtration resulted in substantial reduction of detectable CMV DNA
levels with 99.9% of the LR products expected to have less than 500 GE/mL of CMV DNA. No difference was found between methods (P = .52). CMV genomic leukocyte subset localization was
determined by QA-PCR of fluorescence-activated cell sorter
(FACS)-sorted peripheral blood from 20 seropositive subjects
(n = 10 > 100 GE/mL, n = 10 QA-PCR negative). CMV was detected
in monocyte (13 of 20) and granulocyte (3 of 20) fractions. Presence of
competent virus in QA-PCR positive (> 100 GE/mL) peripheral blood
samples was verified with 4 of 19 subjects positive in shell vial
assay, and 8 of 18 positive for CMV gene products (messenger RNA). We
observed a seasonal DNAemia variation in seropositive subjects. CMV
seropositive subjects (n = 45) entered into longitudinal monitoring
in March/April 1999 were QA-PCR negative at baseline. Subjects
converted to a positive QA-PCR coincident with increased seasonal
allergen levels (Norfolk 15 of 18 evaluable in 43.4 ± 9.48 days;
Denver, 16 of 23 evaluable in 96 ± 26.3 days). These data
demonstrate effective reduction of CMV load by LR during periods of
DNAemia in CMV seropositive subjects.
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