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Cytomegalovirus infection in seropositive unrelated cord blood recipients: a study of 349 Korean patients

Authors
 Meerim Park  ;  Young Ho Lee  ;  Soo Hyun Lee  ;  Keon Hee Yoo  ;  Ki Woong Sung  ;  Hong Hoe Koo  ;  Ji Won Lee  ;  Hyoung Jin Kang  ;  Kyung Duk Park  ;  Hee Young Shin  ;  Hyo Seop Ahn  ;  Jae Wook Lee  ;  Nack-Gyun Chung  ;  Bin Cho  ;  Hack-Ki Kim  ;  Kyung-Nam Koh  ;  Ho Joon Im  ;  Jong Jin Seo  ;  Hee Jo Baek  ;  Hoon Kook  ;  Tai Ju Hwang  ;  Jae Min Lee  ;  Jeong Ok Hah  ;  Yeon Jung Lim  ;  Jun Eun Park  ;  Chuhl Joo Lyu  ;  Young Tak Lim  ;  So Young Chong  ;  Doyeun Oh 
Citation
 Annals of Hematology, Vol.94(3) : 481-489, 2015 
Journal Title
 Annals of Hematology 
ISSN
 0939-5555 
Issue Date
2015
MeSH
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation*/statistics & numerical data ; Cytomegalovirus/immunology ; Cytomegalovirus/physiology ; Cytomegalovirus Infections/complications ; Cytomegalovirus Infections/epidemiology* ; Female ; Humans ; Infant ; Leukemia/complications ; Leukemia/epidemiology* ; Leukemia/immunology ; Leukemia/therapy* ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Seroepidemiologic Studies ; Transplant Recipients/statistics & numerical data* ; Transplantation, Homologous ; Unrelated Donors* ; Virus Activation ; Young Adult
Keywords
Cord blood transplantation ; Cytomegalovirus ; Seropositive ; Outcome
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).
Full Text
http://link.springer.com/article/10.1007%2Fs00277-014-2222-x
DOI
10.1007/s00277-014-2222-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Lyu, Chuhl Joo(유철주) ORCID logo https://orcid.org/0000-0001-7124-7818
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139369
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