Zika virus and its implications on cord blood banking and transplantation

Abstract

KEY IDEAS Umbilical cord blood is an important cellular therapy product used for hematopoietic stem cell transplantation, but the US Food and Drug Administration guidance regarding donor screening to reduce the risk of Zika transmission has decreased the number of licensed, eligible cord blood units available for transplantation. There is a crucial need for updated travel risk assessment for Zika virus transmission, validated screening tests for Zika virus in umbilical cord blood, and further research on Zika virus transmissibility due to umbilical cord blood products to ensure that umbilical cord blood and related tissues are safe and available for transplantation.

Impact of FDA’s HCT/P ZIKV Recommendations on Cord Blood Unit Eligibility and Utilization in a Large Public Cord Blood Bank

“…These CBUs were discarded and not used in transplant. 19 , 20 Another study by the National Cord Blood Program, a public CBB, at New York Blood Center found that 27.5% of units collected from March 2016-December 2018 were ineligible for licensure, and, of these, 76% CBUs were ineligible due to ZIKV-related risk factors. 19 , 21 Of the 196 respondents to a 1-year follow-up survey sent to donors who had ZIKV risk, all mothers reported their infants were healthy.…”

“… 19 , 20 Another study by the National Cord Blood Program, a public CBB, at New York Blood Center found that 27.5% of units collected from March 2016-December 2018 were ineligible for licensure, and, of these, 76% CBUs were ineligible due to ZIKV-related risk factors. 19 , 21 Of the 196 respondents to a 1-year follow-up survey sent to donors who had ZIKV risk, all mothers reported their infants were healthy. 19 This and the current study supports that there are a large number of ineligible CBUs due to ZIKV risk despite lack of reported transmission when these CBUs are used under an IND.…”

“… 19 , 21 Of the 196 respondents to a 1-year follow-up survey sent to donors who had ZIKV risk, all mothers reported their infants were healthy. 19 This and the current study supports that there are a large number of ineligible CBUs due to ZIKV risk despite lack of reported transmission when these CBUs are used under an IND. This is the first recent study with a large sample of donor CBUs collected in the US to report on a high rate of ZIKV-related deferrals and the lower rates of their use.…”

Evaluation of Dengue, Zika virus, and Chikungunya virus transmission by blood components in recipients of haematopoietic stem cell transplantation

“…It is noted that most publications employ molecular biology for the diagnosis of these infectious entities in the immunosuppressed population. The diagnosis based on serology is still little used because it can present a cross-reaction of antibodies developed in response to other flavivirus infections (yellow fever virus, Japanese encephalitis virus, St Louis encephalitis) and other non-flavivirus viruses such asOropouche, Mayaro, and Chikungunya [11][12][13][14][15]. Because the yellow fever vaccine contains attenuated viruses, a cross-reaction of vaccine antibodies may occur with other viruses of the same genus, such as DENV and ZKV.…”