CMV+ donor for a CMV negative recipient SCT
 

Hello -
Your messages and threads have helped me tremendously in the last two years as my husband and I have travelled through this journey.
He was diagnosed with MDS (RA) 18 months ago. After an awful experience with ATG, he actually was doing quite well (relatively speaking) for several months. Imagine our shock returning for a BM biopsy in April and learning his blasts had jumped from less than 5% to 18% (putting him at RAEB-II). We were told to plan on a SCT after 4 months of Vidaza. We were set for transplant, when the biopsy in August showed no change in blasts.
My husband just spent 4 weeks at Moffitt receiving CLAG chemo. His blasts are down to 3%, with another biopsy scheduled for Monday.
We are to move to SCT (unrelated donor) early October.
Today, we learned my husband is CMV negative, and our 10-for-10 match donor is CMV +.
We got nervous last night researching the possible complications from this imbalance (death, coma, blindness, encephalitis, hepatitis, etc.).
Any comments or thoughts on this?
ConfusedSpouseInFlorida

ConfusedSpouseInFlorida,

Transplant doctors will try to avoid having a CMV-sero-positive donor and CMV-sero-negative recipient if there's another donor available. But that's not always the case.

If there isn't a better choice for your husband, because there are no other matched donors or they are less of a match or otherwise riskier, they can proceed. In that case, your husband's transplant doctors are likely to give him drugs to help prevent CMV from activating, and they will test him frequently for CMV infection so he can be treated promptly if it occurs.

Thank you, Neil. There was another 10-for-10 matching donor who is negative for CMV, but he is not available at this time.

Thanks Neil ..Hubby is also cmv- and that is basically what we have been told as well. The possibilty of the cmv+ becoming active - but they will watch him carefully and administer extra meds as needed. Of course they are going to try and locate a cmv- match if at all possible.

Well, here's a disturbing update. Good news was another 10-for-10 match, CMV negative, was found who was available. Like the other donor, this one is a male in his early 20s. Bad news: my husband's mega labs earlier this week uncovered a very recent infection of CMV. Apparently, Moffitt's physician on call in the hematology unit neglected to check the "CMV negative" box, so hubby received blood that was CMV positive. Very, very upset about all this. He was in the heme unit to receive CLAG to lower his blasts in preparation for transplant. He received 2 platelet and 2 RBC transfusions while in-patient. So, now we're told it's best to have the positive donor. He was tested again, and now cannot be tested for another 2 or 3 weeks, and the doctors feel he doesn't have time to wait.