Thanks so much for the feedback. That has been my understanding, that if a patient is CMV Neg. it's best to try and stay that way especially since BMT is not out of the question yet.
I have requested that Yashar be given CMV Neg. blood products Only and also asked that my request be documented on his Medical Chart. She emailed me the following response:
Hi Norma,
I spoke to our blood bank director and he informed me that :Our official policy is that we do not carry CMV-neg, but regard leukoreduction as a safe method to decrease CMV transmission. Although we do not specifically order or inventory CMV-neg blood, some of our blood just happens to be CMV-neg.
So, I will request and if CMV negative here in our supply than he will get it.
I would also like to inform you of the additional information he gave me:
UCSF and LPCH (Stanford) still offer CMV-neg blood for bone marrow transplant when the following 3 conditions are met: if the patient is serologically CMV-neg AND the patient is about to have a transplant at Stanford or UCSF (like within 30 days is what UCSF uses) AND the donor marrow is CMV-neg, . . All of our blood bank, laboratory, and BMT regulatory agencies require that we use either leukoreduced OR CMV-neg blood. In some parts of the country, like the South, the seroprevalence is nearly 100%. So they do BMTs without any CMV-neg blood. Some academic centers like Emory and Yale do not use CMV-neg at all. Many local community hospitals, such as Santa Clara Valley Medical Center, John Muir, Children's Hospital Oakland do not use CMV-neg.
In one famous randomized clinical trial comparing Leukoreduced to CMV-neg blood, there was no difference.
I'm confused about the (3) reasons as it would seem that just being on the transplant list would qualify a CMV-Neg patient to receive CMV-Neg. The whole 30-day deal doesn't make sense to me!