Umbilical cord blood transplantation and cytomegalovirus: posttransplantation infection and donor screening
Umbilical cord blood transplantation and cytomegalovirus: posttransplantation infection and donor screening
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DOI：
10.1182/blood-2006-04-020313
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发表时间：
2006-12-15
期刊：
影响因子：
20.3
通讯作者：
Stevens, Cladd E.
中科院分区：
文献类型：
--
作者：
Albano, Maria S.;Taylor, Patricia;Stevens, Cladd E.
本研究评估了非亲属脐带血（CB）移植后巨细胞病毒（CMV）感染的发生率，并评估了筛选CB供者的策略。移植后CMV感染，在1221名CB受者中有23%，与患者移植前CMV血清学相关（P < 0.001），但与CB供者或其母亲的CMV血清学无关。采用唾液病毒培养法对26 988例婴儿供体进行检测。在2个病例对照研究中，采用CB聚合酶链反应（CB- pcr）评估亚组。在第一项研究中，47例唾液培养阳性的CB供者中有33例经CB- pcr证实。33例确诊CMV感染婴儿的母亲全部CMV-总抗体阳性，但只有1 / 3的母亲有CMV- igm抗体。第二项研究评估了CMV-IgM抗体母亲所生的婴儿。其中，170名唾液培养阴性的婴儿中有5名通过CB-PCR呈阳性。先天性巨细胞病毒感染在CB供体中的发生率较低（0.12%）。母体血清学对其婴儿CB供体CMV感染的预测价值较差，与CB受者CMV感染没有检测到的关系。唾液巨细胞病毒培养有假阳性和阴性结果。CB- pcr是检测CB供体巨细胞病毒的有效替代方法。
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. Posttransplantation CMV infection, reported in 23% of 1221 CB recipients, was associated with patient pretransplantation CMV serology (P < .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 2 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 CMV-total antibody positive, but only 1 of 3 had CMV-IgM antibody. The second study evaluated infants born to mothers with CMV-IgM antibody. Of these, 5 of 170 saliva culture-negative infants were positive by CB-PCR. 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.