Cytomegalovirus infection in seropositive unrelated cord blood recipients: a study of 349 Korean patients

• Published in: Annals of hematology Vol. 94; no. 3; pp. 481 - 489
• Main Authors: Park, Meerim, Lee, Young Ho, Lee, Soo Hyun, Yoo, Keon Hee, Sung, Ki Woong, Koo, Hong Hoe, Lee, Ji Won, Kang, Hyoung Jin, Park, Kyung Duk, Shin, Hee Young, Ahn, Hyo Seop, Lee, Jae Wook, Chung, Nack-Gyun, Cho, Bin, Kim, Hack-Ki, Koh, Kyung-Nam, Im, Ho Joon, Seo, Jong Jin, Baek, Hee Jo, Kook, Hoon, Hwang, Tai Ju, Lee, Jae Min, Hah, Jeong Ok, Lim, Yeon Jung, Park, Jun Eun, Lyu, Chuhl Joo, Lim, Young Tak, Chong, So Young, Oh, Doyeun
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2015; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Child; Child, Preschool; Cord Blood Stem Cell Transplantation - statistics & numerical data; Cytomegalovirus; Cytomegalovirus - immunology; Cytomegalovirus - physiology; Cytomegalovirus Infections - complications; Cytomegalovirus Infections - epidemiology; Female; Graft versus host disease; Hematology; Humans; Infant; Leukemia - complications; Leukemia - epidemiology; Leukemia - immunology; Leukemia - therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Republic of Korea - epidemiology; Seroepidemiologic Studies; Transplant Recipients - statistics & numerical data; Transplantation, Homologous; Transplants & implants; Unrelated Donors; Virus Activation; Young Adult; Republic of Korea; Cytomegalovirus; Outcome; Seropositive; Cord blood transplantation
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-014-2222-x

To gain insight into the natural history of cytomegalovirus (CMV) infection following unrelated cord blood transplantation (UCBT) in seropositive patients, we analyzed the data of 349 seropositive patients who received UCBT in Korea between 2000 and 2011. CMV reactivation occurred in 49 % (171/349) of the CMV-seropositive transplant recipients at a median of 31 days post UCBT. One hundred sixty-four out of 171 patients (96 %) received preemptive therapy. The median duration of CMV reactivation was 29 days. In multivariate analysis, weight >22 kg, use of total body irradiation, use of pre-transplant antithymocyte globulin, graft-versus-host disease (GVHD) prophylaxis with mycophenolate mofetil, and presence of grade II–IV acute GVHD were independent predictors of CMV reactivation. CMV reactivation did not impact transplantation-related mortality (TRM), leukemia relapse, or survival. CMV disease was diagnosed in 62 patients (17.8 %) at a median 55 days after UCBT. Longer duration of CMV reactivation was the only risk factor for progression to CMV disease ( p  = 0.01). CMV disease resulted in higher TRM (56.0 vs. 31.4 %, p  < 0.01) and lower survival (36.1 vs. 55.1 %, p  = 0.02).