Risk of transmission of herpesviruses through cord blood transplantation

Biol Blood Marrow Transplant. 2005 Jan;11(1):35-8. doi: 10.1016/j.bbmt.2004.09.005.

Abstract

Cord blood (CB) progenitor cells are increasingly used for transplantation in children because of the lower risk of graft-versus-host disease compared with unrelated bone marrow and comparable rates of disease-free survival. There is concern that CB might carry a higher risk of opportunistic infections. Human herpesviruses (HHV) are common pathogens in transplant recipients. CB donors are routinely tested for the presence of anti-cytomegalovirus (CMV) immunoglobulin M to reduce the risk of collecting CMV-infected CB. To assess the incidence of beta and gamma HHV infection of CB collected under standard procedures, we tested 362 CB samples for the presence of CMV; HHV-6, -7, and -8; and Epstein-Barr virus DNA by polymerase chain reaction. HHV-6 DNA was found in 2 samples, yielding an incidence of 0.55% (95% confidence interval, 0.1%-2%). None of the other viral DNAs was found, resulting in a 95% confidence interval of 0% to 1% for the incidence of CMV, Epstein-Barr virus, HHV-7, and HHV-8. Because the seroprevalence of HHV-8 among the CB donors in this study was only 4%, these findings cannot be extended to HHV-8-endemic areas. Our data show that screening prospective CB donors with anti-CMV immunoglobulin M practically eliminates the risk of CB CMV transmission, but HHV-6 warrants CB testing by polymerase chain reaction.

MeSH terms

  • Cord Blood Stem Cell Transplantation / adverse effects*
  • Cytomegalovirus / isolation & purification
  • DNA, Viral / blood
  • Disease Transmission, Infectious
  • Fetal Blood / virology
  • Herpesviridae Infections / diagnosis
  • Herpesviridae Infections / epidemiology
  • Herpesviridae Infections / transmission*
  • Herpesvirus 4, Human / isolation & purification
  • Herpesvirus 6, Human / isolation & purification
  • Herpesvirus 7, Human / isolation & purification
  • Herpesvirus 8, Human / isolation & purification
  • Humans
  • Polymerase Chain Reaction
  • Risk
  • Seroepidemiologic Studies

Substances

  • DNA, Viral