{
  "abstract": "Objective: To investigate the impact of collateral cytomegalovirus (CMV) -positive versus CMV-negative donors on the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Method: This retrospective cohort study analyzed CMV-related events and survival outcomes in allo-HSCT recipients with CMV seropositive who received grafts from CMV-negative (CMV-negative donor group) or collateral CMV-positive (collateral CMV-positive donor group) haploidentical donors at Peking University People's Hospital from January 2017 to March 2025. Results: A total of 126 patients were enrolled, including 16 CMV-negative and 58 collateral CMV-positive donors before the availability of letermovir, and 27 CMV-negative and 25 collateral CMV-positive donors after the availability of letermovir. With a median follow-up of 1 091 (660, 1 536) days, before the availability of letermovir in China, the CMV-negative donor group had a significantly higher incidence of refractory CMV viremia (87.5% vs 50.0%, P=0.007) and a longer median duration of first CMV viremia [29 (95% CI: 25-33) vs 17 (95% CI: 15-19) days, P=0.004] than the collateral CMV-positive donor group. The use of letermovir significantly delayed the onset of first post-transplant CMV viremia in both groups: from day 37 (95% CI: 31-43) to day 140 (95%CI: 136-144) in the CMV-negative donor group (P<0.001) and from day 36 (95% CI: 33-39) to day 111 (95% CI: 76-146) in the collateral CMV-positive donor group (P=0.013). With letermovir prophylaxis, the difference in the median duration of the first CMV viremia between the CMV-negative and collateral CMV-positive donor groups was no longer significant [18 (95% CI: 17-19) vs 12 (95%CI: 0-25) days, P=0.313]. Letermovir reduced the incidence of refractory CMV viremia in the CMV-negative donor group (40.7% vs 87.5%, P=0.003), but the incidence remained higher than that in the collateral CMV-positive donor group (40.7% vs 12.0%, P=0.020). Regardless of letermovir use, there were no statistically significant differences in the 3-year overall survival, non-relapse mortality, or cumulative relapse rate between the CMV-negative and collateral CMV-positive donor groups (all P>0.05). Multivariate analysis showed that CMV disease was an independent risk factor for overall survival (HR=3.0, 95%CI: 1.3-7.3, P=0.014) and non-relapse mortality (HR=3.1, 95%CI: 1.1-8.8, P=0.035). Refractory CMV viremia was an independent risk factor for CMV disease (HR=12.0, 95%CI: 2.9-50.7, P=0.001). Logistic regression analysis showed that having a CMV-negative donor status without letermovir prophylaxis was an independent risk factor for refractory CMV viremia (P=0.005) . Conclusion: CMV-negative donors increase the risk of CMV-related events in recipients. Although letermovir prophylaxis mitigates this risk, the incidence of refractory CMV viremia remains higher in the CMV-negative donor group than in the collateral CMV-positive donor group, whereas the overall survival outcomes are comparable between the two donor sources.",
  "abstract_shown": true,
  "affiliations": [
    "Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for Hematologic Diseases, Beijing 100044, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "J Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Y Y Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "X D Mo"
    },
    {
      "affs": [
        0
      ],
      "name": "Y Q Sun"
    },
    {
      "affs": [
        0
      ],
      "name": "M Lyu"
    },
    {
      "affs": [
        0
      ],
      "name": "X Y Pei"
    },
    {
      "affs": [
        0
      ],
      "name": "X S Zhao"
    },
    {
      "affs": [
        0
      ],
      "name": "Y F Cheng"
    },
    {
      "affs": [
        0
      ],
      "name": "H X Fu"
    },
    {
      "affs": [
        0
      ],
      "name": "L P Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "X H Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "X J Huang"
    },
    {
      "affs": [
        0
      ],
      "name": "Y Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d3t2fmwfvfgja.bib",
  "cited_by": 0,
  "doi": "10.3760/cma.j.cn121090-20251016-00470",
  "fulltext_url": "https://europepmc.org/articles/PMC13669438",
  "id": "d3t2fmwfvfgja",
  "issns": [
    "0253-2727",
    "2707-9740"
  ],
  "landing_url": "https://europepmc.org/article/MED/42851177",
  "language": "chi",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Cytomegalovirus and herpesvirus research"
    ]
  ],
  "openalex": "W7221090687",
  "pdf_url": "https://europepmc.org/articles/PMC13669438?pdf=render",
  "pmcid": "PMC13669438",
  "pmid": "42851177",
  "published": "2026-08-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/d3t2fmwfvfgja.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:10Z",
      "native_id": "MED:42851177",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42851177"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Cytomegalovirus and herpesvirus research",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "[The impact of collateral CMV-seropositive and CMV-seronegative donors on the outcomes of allogeneic hematopoietic stem cell transplantation].",
  "title_text": "[The impact of collateral CMV-seropositive and CMV-seronegative donors on the outcomes of allogeneic hematopoietic stem cell transplantation].",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:10Z",
  "url": "https://research.draconitic.com/paper/d3t2fmwfvfgja",
  "venue": "Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi",
  "versions": []
}