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

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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).

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Acknowledgments

This study was supported by a grant of Kyowa Hakko Kirin Korea Co., Ltd., 2011.

Conflict of interest

The authors declare no conflicts of interest.

Authors’ contributions

M. Park designed the study, performed the analysis, and wrote the paper; Y.H. Lee designed the study, performed the research, and reviewed the manuscript; S.H. Lee, K.H. Yoo, K.W. Sung, H.H. Koo, H.J. Kang, K.D. Park, H.Y. Shin, H.S. Ahn, N.G. Chung, B. Cho, H.K. Kim, K.N. Koh, H.J. Im, J.J. Seo, H.J. Baek, H. Kook, T.J. Hwang, J.M. Lee, J.O. Hah, Y.J. Lim, J.E. Park, C.J. Lyu, Y.T. Lim, S.Y. Chong, and D. Oh contributed to the analysis of data.

Participating centers

This study was conducted at the following institutions: College of Medicine, Chungbuk National University, Cheongju; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Hanyang University Medical Center, Hanyang University College of Medicine, Seoul; Cancer Research Institute, Seoul National University College of Medicine, Seoul; Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul; Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul; Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju; Yeungnam University College of Medicine, Daegu; Chungnam National University College of Medicine, Daejon; Ajou University School of Medicine, Suwon; CHA Bundang Medical Center, CHA University, Seongnam; Mokdong Hospital, Ehwa women’s University College of Medicine, Seoul; Yonsei University College of Medicine, Seoul; Gyeongsang National University School of Medicine, Jinju; Pusan National University, School of Medicine, Pusan; National Cancer Center, Goyang; Konkuk University College of Medicine, Seoul; Gachon University Gil Hospital, Gachon University School of Medicine, Incheon; Daegu Fatima Hospital, Daegu, Korea.

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Authors and Affiliations

  1. Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, South Korea

    Meerim Park

  2. Department of Pediatrics, Hanyang University Medical Center, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 133-792, South Korea

    Young Ho Lee

  3. Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea

    Soo Hyun Lee, Keon Hee Yoo, Ki Woong Sung & Hong Hoe Koo

  4. Department of Pediatrics, Cancer Research Institute, College of Medicine, Seoul National University, Seoul, South Korea

    Ji Won Lee, Hyoung Jin Kang, Kyung Duk Park, Hee Young Shin & Hyo Seop Ahn

  5. Department of Pediatrics, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea

    Jae Wook Lee, Nack-Gyun Chung, Bin Cho & Hack-Ki Kim

  6. Department of Pediatrics, Asan Medical Center Children’s Hospital, College of Medicine, University of Ulsan, Seoul, South Korea

    Kyung-Nam Koh, Ho Joon Im & Jong Jin Seo

  7. Department of Pediatrics, Chonnam National University Hwasun Hospital, Medical School, Chonnam National University, Gwangju, South Korea

    Hee Jo Baek, Hoon Kook & Tai Ju Hwang

  8. Department of Pediatrics, College of Medicine, Yeungnam University, Daegu, South Korea

    Jae Min Lee & Jeong Ok Hah

  9. Department of Pediatrics, Chungnam National University, Daejon, South Korea

    Yeon Jung Lim

  10. Department of Pediatrics, School of Medicine, Ajou University, Suwon, South Korea

    Jun Eun Park

  11. Department of Pediatrics, College of Medicine, Yonsei University, Seoul, South Korea

    Chuhl Joo Lyu

  12. Department of Pediatrics, College of Medicine, Pusan National University, Busan, South Korea

    Young Tak Lim

  13. Division of Hematology-Oncology, Department of Internal medicine, CHA Bundang Medical Center, CHA University, Seongnam, South Korea

    So Young Chong & Doyeun Oh

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  1. Meerim Park
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  2. Young Ho Lee
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  7. Ji Won Lee
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  8. Hyoung Jin Kang
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  14. Bin Cho
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  15. Hack-Ki Kim
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  16. Kyung-Nam Koh
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  17. Ho Joon Im
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  18. Jong Jin Seo
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  19. Hee Jo Baek
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  20. Hoon Kook
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  21. Tai Ju Hwang
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  22. Jae Min Lee
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  24. Yeon Jung Lim
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  25. Jun Eun Park
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  26. Chuhl Joo Lyu
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  27. Young Tak Lim
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  28. So Young Chong
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  29. Doyeun Oh
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on behalf of the Cord Blood Transplantation Working Party of the Korean Society of Hematology

Corresponding author

Correspondence to Young Ho Lee.

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Park, M., Lee, Y.H., Lee, S.H. et al. Cytomegalovirus infection in seropositive unrelated cord blood recipients: a study of 349 Korean patients. Ann Hematol 94, 481–489 (2015). https://doi.org/10.1007/s00277-014-2222-x

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  • DOI: https://doi.org/10.1007/s00277-014-2222-x

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