@article {4498,
	title = {Efficiency and risk factors for CMV transmission in seronegative hematopoietic stem cell recipients.},
	journal = {Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation// Biol Blood Marrow Transplant},
	volume = {18},
	year = {2012},
	month = {2012//},
	pages = {1391 - 400},
	address = {United States},
	abstract = {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 {\textcopyright} 2012 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.},
	keywords = {*Antibodies, Viral/im [Immunology], *Bone Marrow Transplantation/ae [Adverse Effects], *Cytomegalovirus Infections/tm [Transmission], *Cytomegalovirus/im [Immunology], *Hematopoietic Stem Cell Transplantation/ae [Adverse Effects], Adult, Antibodies, Viral/bl [Blood], Cytomegalovirus Infections/bl [Blood], Cytomegalovirus Infections/ep [Epidemiology], Cytomegalovirus Infections/im [Immunology], Female, Humans, Incidence, Male, Middle Aged, Proportional Hazards Models, Retrospective Studies, Risk Factors, Tissue Donors, Transplantation, Homologous, United States/ep [Epidemiology]},
	isbn = {1523-6536},
	author = {Pergam, Steven A and Xie, Hu and Sandhu, Ravinder and Pollack, Margaret and Smith, Jeremy and Stevens-Ayers, Terry and Ilieva, Valeria and Kimball, Louise E and Huang, Meei-Li and Hayes, Tracy S and Corey, Lawrence and Boeckh, Michael J}
}
