Cytomegalovirus infection in seropositive unrelated cord blood recipients: a study of 349 Korean patients
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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).
KeywordsCord blood transplantation Cytomegalovirus Seropositive Outcome
This study was supported by a grant of Kyowa Hakko Kirin Korea Co., Ltd., 2011.
Conflict of interest
The authors declare no conflicts of interest.
M. Park designed the study, performed the analysis, and wrote the paper; Y.H. Lee designed the study, performed the research, and reviewed the manuscript; S.H. Lee, K.H. Yoo, K.W. Sung, H.H. Koo, H.J. Kang, K.D. Park, H.Y. Shin, H.S. Ahn, N.G. Chung, B. Cho, H.K. Kim, K.N. Koh, H.J. Im, J.J. Seo, H.J. Baek, H. Kook, T.J. Hwang, J.M. Lee, J.O. Hah, Y.J. Lim, J.E. Park, C.J. Lyu, Y.T. Lim, S.Y. Chong, and D. Oh contributed to the analysis of data.
This study was conducted at the following institutions: College of Medicine, Chungbuk National University, Cheongju; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Hanyang University Medical Center, Hanyang University College of Medicine, Seoul; Cancer Research Institute, Seoul National University College of Medicine, Seoul; Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul; Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul; Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju; Yeungnam University College of Medicine, Daegu; Chungnam National University College of Medicine, Daejon; Ajou University School of Medicine, Suwon; CHA Bundang Medical Center, CHA University, Seongnam; Mokdong Hospital, Ehwa women’s University College of Medicine, Seoul; Yonsei University College of Medicine, Seoul; Gyeongsang National University School of Medicine, Jinju; Pusan National University, School of Medicine, Pusan; National Cancer Center, Goyang; Konkuk University College of Medicine, Seoul; Gachon University Gil Hospital, Gachon University School of Medicine, Incheon; Daegu Fatima Hospital, Daegu, Korea.
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