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Infection Complications in Pediatric Patients With Inborn Errors of Immunity After Umbilical Cord Blood

Zhongling Wei1,2, Ping Wang1, Wenjin Jiang1

  • 1Department of Hematology/Oncology, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China.

Transplant Infectious Disease : an Official Journal of the Transplantation Society
|February 13, 2026
PubMed

Insights

Infections are common in children with inborn errors of immunity (IEIs) after umbilical cord blood transplantation (UCBT). Early-stage infections and bloodstream infections (BSIs) significantly worsen patient outcomes, highlighting the need for targeted surveillance.

Area of Science:

  • Pediatric Hematology/Oncology
  • Immunology
  • Infectious Diseases

Background:

  • Infection is a frequent complication after umbilical cord blood transplantation (UCBT).
  • Data on infection profiles in pediatric patients with inborn errors of immunity (IEIs) in China are limited.
  • This study characterizes infection patterns and their prognostic impact in IEIs children undergoing UCBT.

Purpose of the Study:

  • To investigate infection prevalence and risk factors in pediatric IEIs patients post-UCBT.
  • To determine the prognostic implications of different infection types and stages on patient survival.
  • To inform risk-stratified surveillance and preemptive strategies for high-risk subgroups.

Main Methods:

  • Retrospective analysis of 165 pediatric IEIs patients undergoing UCBT (January 2015 - June 2020).
  • Categorization of post-transplantation period into early (≤30 days) and middle (31-100 days) stages.
  • Statistical analysis to identify predictors of infection and their association with outcomes.

Main Results:

  • 69.7% of patients experienced infections within 100 days post-UCBT.
  • Engraftment failure, low pre-transplant IgM, and specific graft-versus-host disease (GVHD) prophylaxis regimens were linked to increased infection risk.
  • Early-stage infections and bloodstream infections (BSIs) were associated with significantly poorer survival.
  • Bacterial infections, particularly carbapenem-resistant strains, and BSIs correlated with adverse prognosis.

Conclusions:

  • Infections are highly prevalent in pediatric IEIs patients following UCBT.
  • Early-stage infections and BSIs are critical indicators of poor prognosis.
  • Findings support the implementation of risk-stratified surveillance and preemptive interventions for vulnerable patient groups.
Abstract

Keywords:
childrencord blood stem cell transplantationinfectionprimary immunodeficiency diseases

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