Annals of hematology · 2014
Cytomegalovirus infection in seropositive unrelated cord blood recipients: a study of 349 Korean patients.
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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, Cord Blood Transplantation Working Party of the Korean Society of Hematology
Аннотация
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).