Incidence, Severity, Day 100 Treatment Efficacy and Therapy Toxicity of Cytomegalovirus (CMV) Infections with Early Pre-Emptive Therapy in Adult Cord Blood (CB) Transplant Recipients

Introduction: Unrelated donor CB transplantation (CBT) is effective therapy for patients (pts) with high-risk hematologic malignancies without suitable adult donors. CBT, however, can be complicated by CMV infection in seropositive recipients with viremia rates as high as 100%. Moreover, CMV infection is associated with increased transplant-related mortality (TRM) in some reports. Therefore, our center is investigating: 1) the efficacy of pre-transplant ganciclovir (GAN) prophylaxis, 2) the efficacy of early pre-emptive therapy based on frequent serial qPCR monitoring, & 3) anti-viral therapy toxicities. The aim of this strategy is to rapidly eradicate viremia & thereby prevent disease without prohibitive toxicity.