Published online Feb 26, 2019. doi: 10.4252/wjsc.v11.i2.73
Peer-review started: December 12, 2018
First decision: December 24, 2018
Revised: January 14, 2019
Accepted: January 26, 2019
Article in press: January 26, 2019
Published online: February 26, 2019
Umbilical cord blood (UCB) is a valuable source of hematopoietic stem cells (HSCs) and potential alternative for bone marrow transplantation for patients who lack human leukocyte antigen (HLA)-matched donors. The main practical advantages of UCB over other HSC sources are the immediate availability, lower incidence of graft-versus-host disease, minimal risk to the donor, and lower requirement for HLA compatibility. However, the use of UCB is limited by delayed engraftment and poor immune reconstitution, leading to a high rate of infection-related mortality. Therefore, severe infectious complications, especially due to viral pathogens remain the leading cause of morbidity and mortality during the post-UCB transplantation (UCBT) period. In this context, careful screening and excluding the viral-contaminated UCB units might be an effective policy to reduce the rate of UCBT-related infection and mortality. Taken together, complete prevention of the transmission of donor-derived viral pathogens in stem cell transplantation is not possible. However, having the knowledge of the transmission route and prevalence of viruses will improve the safety of transplantation. To the best of our knowledge, there are few studies that focused on the risk of virus transmission through the UCB transplant compared to other HSC sources. This review summarizes the general aspects concerning the prevalence, characteristics, and risk factors of viral infections with a focus on the impact of viral pathogens on cord blood transplantation safety.
Core tip: Severe infectious complications, especially due to viral pathogens remain the leading cause of the post-transplantation morbidity and mortality. In this context, excluding the viral-contaminated umbilical cord blood (UCB) units might be an effective policy to reduce the infection rate after UCB transplantation (UCBT). Complete prevention of the transmission of donor-derived viral pathogens via UCB is not possible. However, having the knowledge of the transmission route and the prevalence of viruses will improve the transplantation safety by controlled patient management. This minireview summarizes the general aspects concerning the prevalence, characteristics and risk factors of viral infections with a focus on the impact on UCBT safety.