Infectious complications following unrelated cord blood transplantation.
BACKGROUND
Infections following cord blood transplantation are just beginning to be defined in the literature. This review will outline infections at death, the epidemiology of individual infections, and the impact of stem cell source.


METHODS
A review of studies published since 2000.


RESULTS
Based on registry data, most studies demonstrate an approximate rate of infection at death of 30-40% among cord blood recipients. Bacterial infections often occur prior to engraftment and increase among patients with graft failure. In addition, there is delayed recovery of the immune response among patients with graft-versus-host disease that leads to viral infections at later time points. The risk of serious infection among children receiving umbilical cord blood (UCB) grafts is comparable to that of children receiving unmanipulated marrow and is lower than that of recipients of a T-cell-depleted stem cell source. Among adult patients, despite an overall higher incidence of serious infections after UCB transplantation as compared with unrelated donor grafts, non-relapse mortality and overall survival were not significantly different between haematopoietic stem cell sources.


CONCLUSIONS
Further studies are needed to confirm these observations and determine whether the risk of infection for cord blood recipients is comparable to that of recipients of unmanipulated marrow.
van Burik
J-A
JA
Division of Infectious Diseases, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA. vanbu004@umn.edu
Brunstein
C G
CG
D000328:Adult; D001424:Bacterial Infections / Q000209:etiology; D002648:Child; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007239:Infections / Q000209:etiology*; D008212:Lymphocyte Depletion; D009181:Mycoses / Q000209:etiology; D012307:Risk Factors; D014777:Virus Diseases / Q000209:etiology