Prevention of Cytomegalovirus Infection by Cytomegalovirus Immune Globulin After Marrow Transplantation

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Abstract
In an effort to prevent cytomegalovirus infection among seronegative patients having marrow transplants, a globulin with high antibody levels against cytomegalovirus was given before and for 11 wk after transplantation in a randomized trial. Among 36 patients who received no prophylactic granulocyte tranfusions, globulin recipients had significantly fewer infections than controls (2 of 17 vs. 8 of 19, P = 0.05 by Fisher''s exact test and P = 0.03 by Mantel-Cox test). Conversely, infection rates were high and unchanged by globulin use among patients who received granulocytes from seropositive donors (7 of 8 recipients vs. 6 of 7 controls). The lack of effect of the globulin among patients receiving transfusions of granulocytes from seropositive donors may suggest that the dose of antibody was insufficient or that antibody is ineffective against virus transmitted in granulocytes. Evidently, cytomegalovirus infection can be prevented by immunoprophylaxis in seronegative patients having marrow transplants who are not given granulocyte transfusions.