title: Impact of cytomegalovirus serostatus on outcome of unrelated cord blood transplantation for adults: a single-institute experience in Japan.
abstract: Cytomegalovirus (CMV) disease is one of the major infectious complications after allogeneic hematopoietic stem cell transplantation (SCT). Several studies have shown that CMV-seropositive patients have a substantial survival disadvantage after bone marrow transplantation (BMT) or peripheral blood SCT (PBSCT). Between August 1998 and February 2006, 101 adult patients underwent myeloablative cord blood transplantation (CBT) from unrelated donors at our institution. Sixteen and 85 patients were CMV-seronegative and CMV-seropositive, respectively, prior to CBT. Outcomes of CBT were compared between CMV-seronegative and CMV-seropositive patients. The cumulative incidences of neutrophil engraftment at 60 d after CBT did not differ between CMV-seronegative and CMV-seropositive patients (100% and 94%, P = 0.09); however, the cumulative incidence of platelet engraftment at 100 d was higher in CMV-seronegative patients than CMV-seropositive patients (100% vs. 86%, P < 0.005). The cumulative incidence of CMV antigenemia at 100 d was lower in CMV-seronegative patients than CMV-seropositive patients (0% vs. 77%, P < 0.001); however, the cumulative incidences of CMV disease did not differ between CMV-seronegative and CMV-seropositive patients (0% vs. 1%, P = 0.84). The probabilities of disease-free survival at 2 yr also did not differ between CMV-seronegative and CMV-seropositive patients (92% vs. 72%, P = 0.16). The outcomes of CBT for CMV-seropositive patients as well as CMV-seronegative patients in our series were favorable. This might be due to effective antiviral therapy for CMV infection. Large-scale studies are needed to determine the impact of recipient CMV serostatus on the outcome of CBT for adults.
authors: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan. atomonar@ims.u-tokyo.ac.jp
authors: Akira
authors: A
authors: Tomonari
authors: Satoshi
authors: S
authors: Takahashi
authors: Jun
authors: J
authors: Ooi
authors: Nobuhiro
authors: N
authors: Tsukada
authors: Takaaki
authors: T
authors: Konuma
authors: Seiko
authors: S
authors: Kato
authors: Senji
authors: S
authors: Kasahara
authors: Tohru
authors: T
authors: Iseki
authors: Takuhiro
authors: T
authors: Yamaguchi
authors: Arinobu
authors: A
authors: Tojo
authors: Shigetaka
authors: S
authors: Asano
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000956:Antigens, Viral / Q000097:blood; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000209:etiology* / Q000821:virology; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000637:transplantation; D011024:Pneumonia, Viral / Q000209:etiology / Q000821:virology; D019172:Transplantation Conditioning; D014766:Viremia / Q000276:immunology
chemical_list: D000956:Antigens, Viral