A multicenter evaluation of pandemic influenza A/H1N1 in hematopoietic stem cell transplant recipients

Reid, Gail; Huprikar, Shirish; Patel, Gopi; Razonable, Raymund R.; Mossad, Sherif B.; Levi, Marilyn E.; Gregg, Kevin; Shoham, Shmuel; Humar, Atul; Adams, William; Kumar, Deepali

doi:10.1111/tid.12116

Cited by 36 publications

(25 citation statements)

References 30 publications

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“…However, no significant difference was observed by univariate analysis. Previous studies revealed GVHD and use of immunosuppressive agents as major risk factors associated with LRTI and mortality [46][47][48]. Because of the small number of patients who developed GVHD in our study, logistic regression analysis could not be performed.…”

Section: Discussionmentioning

confidence: 84%

Significant Transplantation-Related Mortality from Respiratory Virus Infections within the First One Hundred Days in Children after Hematopoietic Stem Cell Transplantation

Hutspardol

Essa

Richardson

et al. 2015

Biology of Blood and Marrow Transplantation

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Respiratory viral infections (RVI) are important in hematopoietic stem cell transplantations (HSCT) and knowledge regarding incidence, morbidity, mortality, and long-term pulmonary complications is limited. We report a study to evaluate incidence and outcomes, both short and long-term, of RVI in children receiving HSCT. Between January 2000 and December 2012, 844 patients underwent hematopoietic stem cell transplantation (HSCT) at the Hospital for Sick Children: 491 were allogeneic and 353 were autologous. When screening for causes of death in the first year after HSCT in the 844 patients, we found that RVI as a cause of death was only evident in the first 100 days after HSCT. Fifty-four (6.5%) patients were found to have an RVI within the first 100 days after HSCT (allogeneic = 32, autologous = 22). Upper and lower respiratory tract infections were documented in 31 (57%) and 23 (43%) patients, respectively. Viruses were parainfluenza (35%), respiratory syncytial virus (28%), influenza (22%), adenovirus (7%), human metapneumovirus (4%), coronavirus (2%), and rhinovirus (2%). Three patients relapsed with their primary disease before day 100 and were excluded. The overall mortality for the remaining 51 patients was 10% (allogeneic = 4, autologous = 1). All 5 deaths were directly attributable to RVI and all 5 deaths occurred in patients with a lower respiratory tract infection. The remaining patients were followed for a median of 4.3 years (range, 1.4 to 11.8) and no chronic pulmonary complications were observed. A clear seasonal pattern for contracting RVI was evident with 65% of total RVI occurring between October and March (35 of 427 versus 19 of 417, P = .03). Given the significant mortality from RVI and the challenges in preventing them, choosing the time to start HSCT, whenever possible, may help prevent RVI and improve outcomes.

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Section: Discussionmentioning

confidence: 84%

Significant Transplantation-Related Mortality from Respiratory Virus Infections within the First One Hundred Days in Children after Hematopoietic Stem Cell Transplantation

Hutspardol

Essa

Richardson

et al. 2015

Biology of Blood and Marrow Transplantation

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“…PVS is a known phenomenon among stem cell transplant and adult SOT recipients, but it has rarely been investigated in LTRs . Gainer et al.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes of influenza infections in lung transplant recipients: a single‐season cohort study

Schuurmans

Isenring

Jungo

et al. 2014

Transplant Infectious Dis

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“…Mortality rates of up to 25% have been reported in HCT patients with lower RTID (108). Retrospective comparative studies suggest more severe outcomes of the pandemic influenza A/H1N1/pdm09 than previous seasonal IV-A, with more patients suffering from lower RTID, hypoxemia, and mortality, where these outcomes were predicted by profound lymphopenia and delayed antiviral therapy (109,110). However, another large retrospective analysis of influenza A/H1N1/pdm09 diagnosed in 286 HCT patients (222 allogeneic, 64 autologous) at 18 months posttransplant reported cough, fever, and rhinorrhea in 85%, 81%, and 49%, respectively (30).…”

Section: Carv-specific Aspects In Transplant Patients Influenza Virusesmentioning

confidence: 99%

Community-Acquired Respiratory Viruses in Transplant Patients: Diversity, Impact, Unmet Clinical Needs

2019

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SUMMARY Patients undergoing solid-organ transplantation (SOT) or allogeneic hematopoietic cell transplantation (HCT) are at increased risk for infectious complications. Community-acquired respiratory viruses (CARVs) pose a particular challenge due to the frequent exposure pre-, peri-, and posttransplantation. Although influenza A and B viruses have a top priority regarding prevention and treatment, recent molecular diagnostic tests detecting an array of other CARVs in real time have dramatically expanded our knowledge about the epidemiology, diversity, and impact of CARV infections in the general population and in allogeneic HCT and SOT patients. These data have demonstrated that non-influenza CARVs independently contribute to morbidity and mortality of transplant patients. However, effective vaccination and antiviral treatment is only emerging for non-influenza CARVs, placing emphasis on infection control and supportive measures. Here, we review the current knowledge about CARVs in SOT and allogeneic HCT patients to better define the magnitude of this unmet clinical need and to discuss some of the lessons learned from human influenza virus, respiratory syncytial virus, parainfluenzavirus, rhinovirus, coronavirus, adenovirus, and bocavirus regarding diagnosis, prevention, and treatment.

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A multicenter evaluation of pandemic influenza A/H1N1 in hematopoietic stem cell transplant recipients

Cited by 36 publications

References 30 publications

Significant Transplantation-Related Mortality from Respiratory Virus Infections within the First One Hundred Days in Children after Hematopoietic Stem Cell Transplantation

Significant Transplantation-Related Mortality from Respiratory Virus Infections within the First One Hundred Days in Children after Hematopoietic Stem Cell Transplantation

Clinical features and outcomes of influenza infections in lung transplant recipients: a single‐season cohort study

Community-Acquired Respiratory Viruses in Transplant Patients: Diversity, Impact, Unmet Clinical Needs

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