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Prepublished online as a Blood First Edition Paper on August 21, 2003; DOI 10.1182/blood-2002-10-3263. This Article Full Text (PDF) All Versions of this Article: 2002-10-3263v1 102/13/4255    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Ljungman, P. Articles by Cordonnier, C. Search for Related Content PubMed PubMed Citation Articles by Ljungman, P. Articles by Cordonnier, C. Social Bookmarking                   What's this? Submitted November 1, 2002 Accepted June 27, 2003 Donor CMV serological status and outcome of CMV seropositive recipients after unrelated donor stem cell transplantation; an EBMT Megafile analysis Per Ljungman*, Ronald Brand, Hermann Einsele, Francesco Frassoni, Dietger Niederwieser, and Catherine Cordonnier Department of Hematology, Huddinge University Hospital, Stockholm, Sweden Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands Department of Medicine, University Hospital, Tuebingen, Germany Department of Hematology, Ospedale San Martino, Genova, Italy Department of Hematology/Oncology, University of Leipzig, Leipzig, Germany Department of Hematology, Hopital Henri Mondor, Creteil, France * Corresponding author; email: per.ljungman{at}medhs.ki.se. Rationale: Cytomegalovirus (CMV) has been a major cause of morbidity and mortality after allogeneic stem cell transplantation (SCT). The importance of the recipient's serological status is paramount. However, the importance of the donor's serological status in CMV seropositive recipients is controversial. We analysed the influence of the donor's CMV status in a large cohort of patients. Methods: 7018 CMV seropositive patients reported to the European Group for Blood and Marrow Transplantation were included. 5910 had undergone HLA-identical sibling and 1108 unrelated donor SCT. Univariate and multivariate proportional hazards models were constructed for survival, event free survival, transplant related mortality, and relapse incidence. Findings: Patients receiving grafts from CMV seropositive HLA-identical sibling donors had the same survival as patients grafted from seronegative donors (HR 1.04; p=.37, 95% c.i. [0.95-1.14]). However, unrelated donor SCT recipients receiving grafts from CMV seropositive donors had an improved 5-year survival (35% vs. 27%; HR=0.8; p=.006), an improved event free survival (30% vs. 22%; HR=0.8; p=.01), and a reduced transplant related mortality (49% vs. 62%; HR=0.7; p<.001). There was no influence on the relapse incidence. The effects of donor CMV status remained in multivariate analyses. The effect of donor status was different among different disease categories. In CML patients, T-cell depletion abrogated the beneficial effect of donor status suggesting that the effect is mediated through transfer of donor immunity. Conclusion: Our data suggests that donor CMV status influences outcome of unrelated SCT. For a CMV seropositive patient, a seropositive donor might be preferable. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: W. Zhou, J. Longmate, S. F. Lacey, J. M. Palmer, G. 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