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PMID: 19786112 Published · ppublish English Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Impact of cytomegalovirus (CMV) reactivation after umbilical cord blood transplantation.

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation ·Vol. 16 ·No. 2 ·2010-02-00 ·Pages 215-22

Beck JC, Wagner JE, DeFor TE, Brunstein CG, Schleiss MR, Young JA, Weisdorf DH, Cooley S, Miller JS, Verneris MR

Abstract

This study investigated the impact of pretransplant cytomegalovirus (CMV) serostatus and posttransplant CMV reactivation and disease on umbilical cord blood transplant (UCBT) outcomes. Between 1994 and 2007, 332 patients with hematologic malignancies underwent UCBT and 54% were CMV seropositive. Pretransplant recipient CMV serostatus had no impact on acute or chronic graft-versus-host disease (aGVHD, cGVHD), relapse, disease-free survival (DFS), or overall survival (OS). There was a trend toward greater day 100 treatment-related mortality (TRM) in CMV-seropositive recipients (P=.07). CMV reactivation occurred in 51% (92/180) of patients with no difference in myeloablative (MA) versus reduced-intensity conditioning (RIC) recipients (P=.33). Similarly, reactivation was not influenced by the number of UCB units transplanted, the degree of HLA disparity, the CD34(+) or CD3(+) cell dose, or donor killer cell immunoglobulin-like receptor (KIR) gene haplotype. Rapid lymphocyte recovery was associated with CMV reactivation (P=.02). CMV reactivation was not associated with aGVHD (P=.97) or cGVHD (P=.65), nor did it impact TRM (P=.88), relapse (P=.62), or survival (P=.78). CMV disease occurred in 13.8% of the CMV-seropositive patients, resulting in higher TRM (P=.01) and lower OS (P=.02). Thus, although recipient CMV serostatus and CMV reactivation have little demonstrable impact on UCB transplant outcomes, the development of CMV disease remains a risk, associated with inferior outcomes.

MeSH Terms
Acute Disease Aging Cord Blood Stem Cell Transplantation/adverse effects Cytomegalovirus/physiology Cytomegalovirus Infections/epidemiology,mortality,virology Female Humans Incidence Male Recurrence Risk Factors Serologic Tests Survival Analysis Time Factors Treatment Outcome Virus Activation
Authors & Affiliations
10 authors, click to expand affiliations / ORCID
Beck Jill C
Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, Minnesota 55455, USA.
Wagner John E
DeFor Todd E
Brunstein Claudio G
Schleiss Mark R
Young Jo-Anne
Weisdorf Daniel H
Cooley Sarah
Miller Jeffrey S
Verneris Michael R
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Article Info
Journal
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Abbr.
Biol Blood Marrow Transplant
ISSN
1523-6536
DOI
10.1016/j.bbmt.2009.09.019
Published
2010-02-00
Epub
2009-00-26
Pages
215-22
Language
English
Region
United States
NLM ID
9600628
PMCID
PMC2819578
Subset
IM
Grants
NCI NIH HHS · P01 CA65493 · United States
NCI NIH HHS · P01 CA065493 · United States
PHS HHS · P01 111412 · United States
NCI NIH HHS · P01 CA111412-01A1 · United States
NCI NIH HHS · P01 CA111412 · United States
External Links
PubMed source DOI: 10.1016/j.bbmt.2009.09.019 PMC Full Text
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