Synapse - Incidence, nature and mortality of cytomegalovirus infection after double-unit cord blood transplant

Incidence, nature and mortality of cytomegalovirus infection after double-unit cord blood transplant Journal Article

Authors:	Dahi, P. B.; Perales, M. A.; Devlin, S. M.; Olson, A.; Lubin, M.; Gonzales, A. M.; Scaradavou, A.; Kernan, N. A.; O'Reilly, R. J.; Giralt, S.; Jakubowski, A.; Koehne, G.; Papadopoulos, E. B.; Ponce, D. M.; Sauter, C.; Papanicolaou, G.; Barker, J. N.
Article Title:	Incidence, nature and mortality of cytomegalovirus infection after double-unit cord blood transplant
Abstract:	Cord blood transplant (CBT) extends allograft access but is associated with a significant risk for cytomegalovirus (CMV) infection. We analyzed CMV infection in 157 CBT recipients transplanted for hematological malignancies. As compared with antigenemia testing, routine polymerase chain reaction (PCR) monitoring was associated with increased and earlier CMV infection detection (1-year incidence if seropositive 67% [median onset 41 days] vs. 100% at an earlier 33-day median [p < 0.001]) and decreased gastrointestinal disease. One-year CMV-related transplant-related mortality was 11% in CMV+ patients with 7/9 deaths associated with initial infection. Disease-free survival was lower in seropositive compared with seronegative patients (1-year: 55% vs. 73%, p = 0.02). However, in multivariate analysis adjusting for age, treatment failure risk in CMV+ patients was not significant (hazard ratio 1.52, p = 0.11). CMV infection is a major challenge in seropositive CBT recipients. While PCR surveillance permits early detection of viremia, new prophylaxis and therapeutic strategies are needed. © 2014 Informa UK, Ltd.
Keywords:	adolescent; adult; child; aged; treatment failure; major clinical study; disease free survival; polymerase chain reaction; oxygen therapy; aciclovir; herpes simplex; retrospective study; cord blood; blood transfusion; graft versus host reaction; corticosteroid; calcineurin inhibitor; cyclosporin a; granulocyte colony stimulating factor; foscarnet; ganciclovir; cytomegalovirus infection; cytomegalovirus; chickenpox; virus pneumonia; thymocyte antibody; virus reactivation; antiviral therapy; valganciclovir; lung lavage; allogeneic transplant; transplant-related mortality; umbilical cord blood transplantation; mycophenolate mofetil; human; male; female; priority journal; article
Journal Title:	Leukemia and Lymphoma
Volume:	56
Issue:	6
ISSN:	1042-8194
Publisher:	Taylor & Francis Group
Date Published:	2015-06-01
Start Page:	1799
End Page:	1805
Language:	English
DOI:	10.3109/10428194.2014.963079
PROVIDER:	scopus
PMCID:	PMC4405462
PUBMED:	25224458
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84932137708&partnerID=40&md5=90fb4ba2ead8f0fb9913a673b0a12f9a
Notes:	Export Date: 3 August 2015 -- Source: Scopus