Temporal trends in transfusion-transmitted cytomegalovirus infection among cytomegalovirus-seronegative HSCT recipients

BACKGROUND: The incidence of transfusion-transmitted cytomegalovirus (TT-CMV) after hematopoietic stem cell transplantation (HSCT) in the era of universal leukoreduction remains unclear. This study evaluated temporal changes in TT-CMV and clinically significant CMV infection (csCMVi) in Japan. METHODS: Data from 5,016 CMV-seronegative HSCT recipients registered between 1999 and 2022 were retrospectively analyzed. TT-CMV was defined as CMV antigenemia and/or CMV disease, and csCMVi as the initiation of pre-emptive therapy or CMV disease. RESULTS: Random donor (RD) blood products were independently associated with TT-CMV (odds ratio 2.35, 95% confidence interval 1.75-3.15, P < 0.001) and csCMVi (subdistribution hazard ratio 2.22, 95% CI 1.67-2.96, P < 0.001). Among allogeneic HSCT recipients receiving RD blood products, TT-CMV decreased from 25.7% in 2007-2020 to 12.7% in 2021-2022, while the 100-day cumulative incidence of csCMVi decreased from 24.7% to 8.3% over the same periods. During 2021-2022, differences between RD and CMV-seronegative donor blood products were not statistically significant. CMV disease incidence did not differ between groups. CONCLUSIONS: TT-CMV and csCMVi decreased substantially over time. Although RD blood products remained associated with higher overall risk, the additional benefit of CMV-seronegative blood products may be limited under contemporary transfusion practices.

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Journal
International Journal of Hematology
Published
2026-10-15
DOI
https://doi.org/10.1007/s12185-026-04295-y
Primary Topic
Cytomegalovirus and herpesvirus research
Type
article
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article

Temporal trends in transfusion-transmitted cytomegalovirus infection among cytomegalovirus-seronegative HSCT recipients

Naoyuki Uchida, Ryu Yanagisawa, Satoshi Okada, Noriko Doki et al.
International Journal of Hematology
Cytomegalovirus and herpesvirus research
article

Temporal trends in transfusion-transmitted cytomegalovirus infection among cytomegalovirus-seronegative HSCT recipients

Naoyuki Uchida, Ryu Yanagisawa, Satoshi Okada, Noriko Doki, Kimikazu Yakushijin, Yoshiko Atsuta, Michiko Kajiwara, Fumihiko Ishimaru, Hideki Nakasone, Sachiko Seo, Motoshi Ichikawa, Makoto Onizuka, Masao Ogata, Satoshi Yoshihara, Mineo Kurokawa, Takahiro Fukuda, Nobuhiro Tsukada, Youko Suehiro, Shinichi Ito, Masatsugu Tanaka, Daiichiro Hasegawa, Yoshinobu Kanda, Yoshiyuki Takahashi, the Transplant Complications Working Group. of the Japanese Society for Transplantation and Cellular Therapy (JSTCT), Shingo Yano
article en

Abstract

BACKGROUND: The incidence of transfusion-transmitted cytomegalovirus (TT-CMV) after hematopoietic stem cell transplantation (HSCT) in the era of universal leukoreduction remains unclear. This study evaluated temporal changes in TT-CMV and clinically significant CMV infection (csCMVi) in Japan. METHODS: Data from 5,016 CMV-seronegative HSCT recipients registered between 1999 and 2022 were retrospectively analyzed. TT-CMV was defined as CMV antigenemia and/or CMV disease, and csCMVi as the initiation of pre-emptive therapy or CMV disease. RESULTS: Random donor (RD) blood products were independently associated with TT-CMV (odds ratio 2.35, 95% confidence interval 1.75-3.15, P < 0.001) and csCMVi (subdistribution hazard ratio 2.22, 95% CI 1.67-2.96, P < 0.001). Among allogeneic HSCT recipients receiving RD blood products, TT-CMV decreased from 25.7% in 2007-2020 to 12.7% in 2021-2022, while the 100-day cumulative incidence of csCMVi decreased from 24.7% to 8.3% over the same periods. During 2021-2022, differences between RD and CMV-seronegative donor blood products were not statistically significant. CMV disease incidence did not differ between groups. CONCLUSIONS: TT-CMV and csCMVi decreased substantially over time. Although RD blood products remained associated with higher overall risk, the additional benefit of CMV-seronegative blood products may be limited under contemporary transfusion practices.

International Journal of Hematology
Hiroshima University (JP), Jikei University School of Medicine (JP), Tokai University (JP), Hyogo Medical University (JP), Jichi Medical University (JP), Aichi Medical University (JP), Oita University (JP), Japanese Red Cross Society, Japan (JP), NTT Medical Center (JP), Tokyo Metropolitan Komagome Hospital (JP), Kobe University Hospital (JP), National Hospital Organization Kyushu Cancer Center (JP), Japanese Red Cross Medical Center (JP), University of Tokyo Hospital (JP), Tokai University Hospital (JP), Kobe Children's Hospital (JP), Shinshu University Hospital (JP), Tokyo Women's Medical University (JP), Oita University Hospital (JP), The Japanese Data Center for Hematopoietic Cell Transplantation (JP), Tokyo Medical and Dental University Hospital (JP), Jichi Medical University Saitama Medical Center (JP), Toranomon Hospital (JP), Kanagawa Cancer Center, Hakodate Municipal Hospital (JP), Hyogo Medical University Hospital (JP), National Cancer Center Hospital (JP), Nagoya University (JP), The University of Tokyo (JP), Saitama Medical University (JP)
Good health and well-being
Openalex Percentile: Top 12%
Cytomegalovirus and herpesvirus research
DOIOpen Access PDFOpenAlex
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