Submitted April 27, 2006
Accepted July 27, 2006
Umbilical cord blood transplantation and cytomegalovirus: post-transplant infection and donor screening
Maria S Albano, Patricia Taylor, Robert F Pass, Andromachi Scaradavou, Rodica Ciubotariu, Carmelita Carrier, Ludy Dobrila, Pablo Rubinstein, and Cladd E Stevens*
New York Blood Center
Department of Pediatrics, UAB School of Medicine, 1600 7th Avenue South, Birmingham, AL
* Corresponding author; email: cstevens{at}nybloodcenter.org.
This study assessed the incidence of cytomegalovirus (CMV) infection after transplantation of cord blood (CB) from unrelated donors and evaluated strategies for screening CB donors. Post-transplant CMV infection, reported in 23% of 1221 CB recipients, was associated with patient pre-transplant CMV serology (p<0.001), but not with CMV serology in CB donors or their mothers. A total of 26,988 infant CB donors were evaluated by viral culture of saliva. Subgroups were evaluated by polymerase chain reaction in CB (CB-PCR) in two case-control studies. In the first study, 33 of 47 saliva culture positive CB donors were confirmed by CB-PCR. All mothers of the 33 infants with confirmed CMV infection were total-CMV antibody positive, but only 1/3 had IgM-CMV antibody. The second study evaluated infants born to mothers with IgM-CMV antibody. Of these, 5 of 170 saliva culture negative infants were positive by CB-PCR. Conclusions: The incidence of congenital CMV infection in CB donors was low (0.12%). Maternal serology had poor predictive value for CMV infection in their infant CB donors and bore no detected relationship to CMV infection in CB recipients. Saliva culture for CMV had both false positive and negative results. CB-PCR was a useful alternative for detecting CMV in CB donors.
