In patients with hematologic malignancies, the outcome of umbilical cord blood transplantation has improved and is now comparable to that of matched unrelated donor transplantation. However, the limitation of using umbilical cord blood has been a delay in both hematopoietic and immunologic recovery. Strategies have been proposed to overcome these limitations. One strategy involves ex vivo expansion of the umbilical cord blood unit prior to transplantation. A second strategy involves exposure of the umbilical cord blood graft to compounds aimed at improving homing and engraftment following transplantation. Many of these strategies are now being tested in late phase multi-center clinical trials. If proven cost effective and efficacious, they may alter the landscape of donor options for allogeneic stem cell transplantation.

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Intracranial abscesses are rare complications of Streptococcus pneumoniae infections, and to our knowledge, there have been no case reports of post-infectious vasculitis developing in such patients. Here we describe the case of a 48-year-old post-splenectomy male who developed post-infectious vasculitis following S. pneumoniae otitis media complicated by mastoiditis, osteomyelitis, meningitis, and intracranial abscess. Clinicians ought to be aware of the possible adverse outcomes of invasive S. pneumoniae and the limitations of current treatment options.

GVHD (Figure 3B). We observed no difference in IL-15, CXCL10 and CXCL9 levels in patients with and without GVHD. Conclusion: Maraviroc administration was feasible in children but was limited by elevated bilirubin levels and transaminases, unrelated to maraviroc. We achieved successful CCR5 blockade but also observed breakthrough of GVHD due to failure to administer maraviroc consistently. Peripheral blood activation of T-cell lymphocytes occurs in patients with imminent acute GVHD despite maraviroc prophylaxis, as might be expected since maraviroc regulates lymphocyte homing but does not suppress activation.

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