Immunogenicity of a Lived-Attenuated Japanese Encephalitis Vaccine in Children after Hematopoietic Stem Cell Transplantation

Abstract

actively treated for graft-versus-host disease (GVHD). The median (range) ANC and ALC at the time of RSV diagnosis was 1.6 (0 -11) and 0.8 (0 -7.3), respectively. Among the 35 patients with URTI, 12 received IR while 23 did not. None of the 12 patients treated with IR progressed to LRTI. In contrast, 6 of the 23 untreated patients (24%) with URTI progressed to LRTI. Of the 31 patients with LRTI (25 initially diagnosed with LRTI and 6 patients who progressed from URTI to LRTI), there were four deaths occurring within 60 days of RSV diagnosis (two deaths directly from RSV, one from disease relapse, and one from GVHD). In patients with LRTI (25 patients with LRTI at diagnosis plus 6 patients who progressed from URTI to LRTI), RSV-related mortality was (6.4%). On univariate analysis, only the presence of GVHD significantly predicted the development of LRTI in patients with URTI (P ¼ .028); however, the use of inhaled ribavirin had a protective effect that was marginally significant (P¼ .074). Early use of IR in high-risk transplant and leukemia patients can both reduce the progression from URTI to LRTI and improve the historically dismal outcomes of patients with RSV pneumonia.Abstracts / Biol Blood Marrow Transplant 20 (2014) S184eS210 S198