title: Cytomegalovirus infection in seropositive unrelated cord blood recipients: a study of 349 Korean patients.
abstract: 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).
authors.affiliation: Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, South Korea.
authors.forename: Meerim
authors.initials: M
authors.lastname: Park
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Lee
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Keon Hee
authors.initials: KH
authors.lastname: Yoo
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Sung
authors.forename: Hong Hoe
authors.initials: HH
authors.lastname: Koo
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Hyoung Jin
authors.initials: HJ
authors.lastname: Kang
authors.forename: Kyung Duk
authors.initials: KD
authors.lastname: Park
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Shin
authors.forename: Hyo Seop
authors.initials: HS
authors.lastname: Ahn
authors.forename: Jae Wook
authors.initials: JW
authors.lastname: Lee
authors.forename: Nack-Gyun
authors.initials: NG
authors.lastname: Chung
authors.forename: Bin
authors.initials: B
authors.lastname: Cho
authors.forename: Hack-Ki
authors.initials: HK
authors.lastname: Kim
authors.forename: Kyung-Nam
authors.initials: KN
authors.lastname: Koh
authors.forename: Ho Joon
authors.initials: HJ
authors.lastname: Im
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Seo
authors.forename: Hee Jo
authors.initials: HJ
authors.lastname: Baek
authors.forename: Hoon
authors.initials: H
authors.lastname: Kook
authors.forename: Tai Ju
authors.initials: TJ
authors.lastname: Hwang
authors.forename: Jae Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Jeong Ok
authors.initials: JO
authors.lastname: Hah
authors.forename: Yeon Jung
authors.initials: YJ
authors.lastname: Lim
authors.forename: Jun Eun
authors.initials: JE
authors.lastname: Park
authors.forename: Chuhl Joo
authors.initials: CJ
authors.lastname: Lyu
authors.forename: Young Tak
authors.initials: YT
authors.lastname: Lim
authors.forename: So Young
authors.initials: SY
authors.lastname: Chong
authors.forename: Doyeun
authors.initials: D
authors.lastname: Oh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000706:statistics & numerical data; D003587:Cytomegalovirus / Q000276:immunology / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000150:complications / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D066027:Transplant Recipients / Q000706:statistics & numerical data*; D014184:Transplantation, Homologous; D061349:Unrelated Donors; D014775:Virus Activation; D055815:Young Adult