This study investigated the impact of pre-transplant 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. Pre-transplant recipient CMV
serostatus had no impact on acute or chronic GVHD, 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=0.07). CMV reactivation occurred
in 51% (92/180) of patients with no difference in myeloablative (MA) versus reducedintensity
conditioning (RIC) recipients (p=0.33). 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 immunoglobulin-like receptor (KIR) gene
haplotype. Rapid lymphocyte recovery was associated with CMV reactivation (p=0.02).
CMV reactivation was not associated with acute (p=0.97) or chronic GVHD (p=0.65),
nor did it impact TRM (p=0.88), relapse (p=0.62) or survival (p=0.78). CMV disease
occurred in 13.8% of the CMV-seropositive patients, resulting in higher TRM (p=0.01)and lower OS (p=0.02). 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.
University of Minnesota M.S. thesis. May 2010. Major: Clinical Research. Advisor: Michael R. Verneris, MD. 1 computer file (PDF); vi, 25 pages.
Beck, Jill Catherine . MD..
Impact of cytomegalovirus (CMV) reactivation after umbilical cord blood transplantation..
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