Infectious Complications After Umbilical Cord Blood Transplantation for Hematological Malignancy

Linder, Kathleen A; McDonald, Philip J; Kauffman, Carol A; Revankar, Sanjay G; Chandrasekar, Pranatharthi H; Miceli, Marisa H

In the current study, we describe the burden of infectious complications in adult patients after UCBT. Prior studies have demonstrated the high infection risk in children after this procedure, but there are contradictory studies regarding the risk of infection in adult patients after UCBT [5, 6, 18] . Viral infections have been associated with excess morbidity and mortality after UCBT [6, 13, 19] . Cytomegalovirus reactivation has been of particular concern. Positive CMV serostatus of the recipient and use of ATG or monoclonal T-cell antibodies during conditioning are known risk factors for CMV reactivation and increased mortality after UCBT [6, [20] [21] [22] . Previous studies of infection after UCBT found rates of CMV reactivation from 21% to 64% and noted that these rates were higher than those noted after allogeneic HCT [13, 18, [22] [23] [24] . The use of ATG at conditioning in UCBT recipients has previously been associated with increased risk of CMV reactivation [13] . In our study, CMV reactivation was not associated with ATG use, but only 3 patients had received this agent. Cytomegalovirus infection did not contribute to the death of any patient in our cohort.