CMV donor/recipient serostatus was analyzed in 200 patients allografted in our institution from unrelated (122 patients) donors and 78 sibling donors in the years 2002–2011 in relation to posttransplant complications. On a group basis independently of the CMV serostatus of donor-recipient pairs sibling transplantations and those from unrelated donors that matched 10/10 at allele level had a similar rate of CMV reactivation (17/78 versus 19/71, ). The rate of CMV reactivation/infection was higher in patients grafted from donors accepted at the lower level of matching than 10/10 (18/38 versus 36/149, ). The incidence of aGvHD followed frequencies of CMV reactivation in the tested groups, being 40/156 and 25/44 in patients grafted from sibling or unrelated donors that 10/10 matched and in those grafted from donors taht HLA mismatched, respectively ( ). Regarding the rate of reactivation in both groups seropositive patients receiving a transplant from seronegative donors had more frequently CMV reactivation as compared to those with another donor-recipient matching CMV serostatus constellation (22/43 versus 32/143, ). Multivariate analysis revealed that seropositivity of recipients with concomitant seronegativity of donors plays an independent role in the CMV reactivation/infection ( , ; , ; , for optimally matched and mismatched patients and the whole group of patients, resp.). 1. Introduction Donor-recipient matching for unrelated hematopoietic stem cell transplantation (HSCT) in addition to human leukocyte antigens (HLA) includes CMV serostatus of the donor and recipient to facilitate the decision [1, 2]. In the clinical practice the presence of CMV IgM antibodies is suggestive of the active infection/reactivation and the presence of IgG antibodies indicates prior infection and shows CMV immunological competence of individuals [3–5]. Unfortunately, it is very suggestive that IgG CMV antibody positive individuals harbor CMV in a latent form and their blood products are infective for CMV incompetent recipients [6]. In the present era of specific anti-CMV chemotherapy the significant impact of pretransplant donor seropositivity on the patient outcome is controversial—reviewed in the Boeckh and Nichols paper [7]. However, recipient CMV serostatus still remains an important risk factor of the patient outcome [8, 9]. HSCT involving pairs in which both donor and recipient lack CMV IgG antibodies is associated with a lower transplant mortality [10]. In the latter situation we are dealing with a donor-recipient pair in which probably neither donor nor recipient
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