Impact of Cytomegalovirus (CMV) Reactivation after Umbilical Cord Blood Transplantation

Jill C. Beck, John E. Wagner, Todd E. DeFor, Claudio G. Brunstein, Mark R. Schleiss, Jo Anne Young, Daniel H. Weisdorf, Sarah Cooley, Jeffrey S. Miller, Michael R. Verneris

Research output: Contribution to journalArticle

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Abstract

This study investigated the impact of pretransplant cytomegalovirus (CMV) serostatus and posttransplant CMV reactivation and disease on umbilical cord blood transplant (UCBT) outcomes. Between 1994 and 2007, 332 patients with hematologic malignancies underwent UCBT and 54% were CMV seropositive. Pretransplant recipient CMV serostatus had no impact on acute or chronic graft-versus-host disease (aGVHD, cGVHD), relapse, disease-free survival (DFS), or overall survival (OS). There was a trend toward greater day 100 treatment-related mortality (TRM) in CMV-seropositive recipients (P = .07). CMV reactivation occurred in 51% (92/180) of patients with no difference in myeloablative (MA) versus reduced-intensity conditioning (RIC) recipients (P = .33). Similarly, reactivation was not influenced by the number of UCB units transplanted, the degree of HLA disparity, the CD34+ or CD3+ cell dose, or donor killer cell immunoglobulin-like receptor (KIR) gene haplotype. Rapid lymphocyte recovery was associated with CMV reactivation (P = .02). CMV reactivation was not associated with aGVHD (P = .97) or cGVHD (P = .65), nor did it impact TRM (P = .88), relapse (P = .62), or survival (P = .78). CMV disease occurred in 13.8% of the CMV-seropositive patients, resulting in higher TRM (P = .01) and lower OS (P = .02). Thus, although recipient CMV serostatus and CMV reactivation have little demonstrable impact on UCB transplant outcomes, the development of CMV disease remains a risk, associated with inferior outcomes.

Original languageEnglish (US)
Pages (from-to)215-222
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume16
Issue number2
DOIs
StatePublished - Feb 1 2010

Fingerprint

Cytomegalovirus
Fetal Blood
Transplantation
Transplants
Survival
Mortality
KIR Receptors
Recurrence
Graft vs Host Disease
Hematologic Neoplasms
Haplotypes
Disease-Free Survival
Therapeutics
Lymphocytes

Keywords

  • Cord blood transplantation
  • Cytomegalovirus
  • GVHD
  • Prophylaxis

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Beck, J. C., Wagner, J. E., DeFor, T. E., Brunstein, C. G., Schleiss, M. R., Young, J. A., ... Verneris, M. R. (2010). Impact of Cytomegalovirus (CMV) Reactivation after Umbilical Cord Blood Transplantation. Biology of Blood and Marrow Transplantation, 16(2), 215-222. https://doi.org/10.1016/j.bbmt.2009.09.019

Impact of Cytomegalovirus (CMV) Reactivation after Umbilical Cord Blood Transplantation. / Beck, Jill C.; Wagner, John E.; DeFor, Todd E.; Brunstein, Claudio G.; Schleiss, Mark R.; Young, Jo Anne; Weisdorf, Daniel H.; Cooley, Sarah; Miller, Jeffrey S.; Verneris, Michael R.

In: Biology of Blood and Marrow Transplantation, Vol. 16, No. 2, 01.02.2010, p. 215-222.

Research output: Contribution to journalArticle

Beck, JC, Wagner, JE, DeFor, TE, Brunstein, CG, Schleiss, MR, Young, JA, Weisdorf, DH, Cooley, S, Miller, JS & Verneris, MR 2010, 'Impact of Cytomegalovirus (CMV) Reactivation after Umbilical Cord Blood Transplantation', Biology of Blood and Marrow Transplantation, vol. 16, no. 2, pp. 215-222. https://doi.org/10.1016/j.bbmt.2009.09.019
Beck, Jill C. ; Wagner, John E. ; DeFor, Todd E. ; Brunstein, Claudio G. ; Schleiss, Mark R. ; Young, Jo Anne ; Weisdorf, Daniel H. ; Cooley, Sarah ; Miller, Jeffrey S. ; Verneris, Michael R. / Impact of Cytomegalovirus (CMV) Reactivation after Umbilical Cord Blood Transplantation. In: Biology of Blood and Marrow Transplantation. 2010 ; Vol. 16, No. 2. pp. 215-222.
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abstract = "This study investigated the impact of pretransplant cytomegalovirus (CMV) serostatus and posttransplant CMV reactivation and disease on umbilical cord blood transplant (UCBT) outcomes. Between 1994 and 2007, 332 patients with hematologic malignancies underwent UCBT and 54{\%} were CMV seropositive. Pretransplant recipient CMV serostatus had no impact on acute or chronic graft-versus-host disease (aGVHD, cGVHD), relapse, disease-free survival (DFS), or overall survival (OS). There was a trend toward greater day 100 treatment-related mortality (TRM) in CMV-seropositive recipients (P = .07). CMV reactivation occurred in 51{\%} (92/180) of patients with no difference in myeloablative (MA) versus reduced-intensity conditioning (RIC) recipients (P = .33). Similarly, reactivation was not influenced by the number of UCB units transplanted, the degree of HLA disparity, the CD34+ or CD3+ cell dose, or donor killer cell immunoglobulin-like receptor (KIR) gene haplotype. Rapid lymphocyte recovery was associated with CMV reactivation (P = .02). CMV reactivation was not associated with aGVHD (P = .97) or cGVHD (P = .65), nor did it impact TRM (P = .88), relapse (P = .62), or survival (P = .78). CMV disease occurred in 13.8{\%} of the CMV-seropositive patients, resulting in higher TRM (P = .01) and lower OS (P = .02). Thus, although recipient CMV serostatus and CMV reactivation have little demonstrable impact on UCB transplant outcomes, the development of CMV disease remains a risk, associated with inferior outcomes.",
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