Objective:Thisretrospectivestudyexaminedriskfactorsforcytomegalovirus(CMV)infectionafterumbilicalcordbloodtransplantation(UCBT)andtheimpactofCMVinfectiononpatientsurvival.Methods:Inall176patients,plasmaCMVDNAwasnegativepriortothetransplantation,andexaminedtwiceaweekfor100d,andthenonceweeklyforadditional300d.Preemptiveantiviraltherapy(ganciclovirorfoscarnet)wasstartedinpatientswith>1,000/mLcopiesofCMVDNAbutnofull-blownCMVdisease,andwasdiscontinuedupontwoconsecutivenegativereportsofbloodCMVDNAtest.ThesurvivalandriskfactorsforCMVinfectionordiseasewereexaminedusinglogisticregression.Results:CMVinfectiondevelopedin71%(125/176)ofthepatients,withamedianonsetof32d.Fourpatients(2.3%)developedCMVdisease.Neitherthe5-yearoverallsurvival(OS)norevent-freesurvival(EFS)differedsignificantlyininfectedpatientsvs.thosewithnoinfection(59.4%vs.64.8%,P=0.194;53.4%vs.59.1%,P=0.226).AstepwisemultivariateanalysisindicatedanassociationofCMVinfectionwithage,high-doseglucocorticoids,thenumberoftransplantedCD34+cells,andthenumberofplatelettransfusion,butnotwithgender,theconditioningregimen,andthedayofneutrophilrecoveryandchronicgraft-versushostdisease(cGVHD).Conclusions:CMVinfectionisverycommonafterUCBT,butdoesnotseemtoaffectlong-termsurvivalwithpreemptiveantiviraltreatment.
