title: Infectious complications after unrelated umbilical cord blood transplantation in adult patients with hematologic malignancies.
abstract: Unrelated umbilical cord blood (UCB) is being increasingly used as an alternative stem cell source for allogeneic stem cell transplantation (allo-SCT). This retrospective study assessed infectious complications occurring in adult patients after UCB transplantation (UCBT). 31 patients received a single (n=4) or double UCBT (n=27) with a median dose of 4.7x10(7) nucleated cells/kg (range: 2.4-7.7). Patients received either a reduced-intensity conditioning (RIC; n=23) or a standard myeloablative (MA) regimen (n=8). The cumulative incidence of neutrophil recovery was 90%. Neutrophil recovery was achieved at a median time of 24 (range: 8-60) days after UCBT. The cumulative incidences of bacterial, fungal, and parasitic infections were, respectively, 16%, 10%, and 6%. Bloodstream infections were neither lethal nor required any intensive care therapy. Similarly, invasive fungal infections and parasitic infections did not cause any death in those patients with sustained engraftment. Although the cumulative incidence of cytomegalovirus (CMV) recurrence was 21%, no CMV disease was observed. With a median follow-up of 10 (range: 3-30) months, 10 patients have died (relapse, n=5; nonrelapse mortality, [NRM] n=5). Overall, the cumulative incidence of infectious-related mortality (IRM) was 8%. In conclusion, this data suggests that UCBT can be performed in adult patients with hematologic malignancies with an acceptable incidence of IRM provided a sufficient dose of nucleated cells is infused to the patient.
authors.affiliation: CHU de Nantes, Service d'Hématologie Clinique, Nantes, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Cahu
authors.forename: Fanny
authors.initials: F
authors.lastname: Rialland
authors.forename: Cyrille
authors.initials: C
authors.lastname: Touzeau
authors.forename: Patrice
authors.initials: P
authors.lastname: Chevallier
authors.forename: Thierry
authors.initials: T
authors.lastname: Guillaume
authors.forename: Jacques
authors.initials: J
authors.lastname: Delaunay
authors.forename: Sameh
authors.initials: S
authors.lastname: Ayari
authors.forename: Viviane
authors.initials: V
authors.lastname: Dubruille
authors.forename: Steven
authors.initials: S
authors.lastname: Le Gouill
authors.forename: Beatrice
authors.initials: B
authors.lastname: Mahe
authors.forename: Thomas
authors.initials: T
authors.lastname: Gastinne
authors.forename: Nicolas
authors.initials: N
authors.lastname: Blin
authors.forename: Beatrice
authors.initials: B
authors.lastname: Saulquin
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Harousseau
authors.forename: Philippe
authors.initials: P
authors.lastname: Moreau
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000328:Adult; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D007239:Infections / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019172:Transplantation Conditioning; D016896:Treatment Outcome; D055815:Young Adult