Safety and Tolerability of Oseltamivir Prophylaxis in Hematopoietic Stem Cell Transplant Recipients: A Retrospective Case-Control Study

Vu, Debie; Peck, Angela J.; Nichols, W. Garrett; Varley, Cara D.; Englund, Janet A.; Corey, Lawrence; Boeckh, Michael

doi:10.1086/518985

Cited by 80 publications

(52 citation statements)

References 16 publications

(27 reference statements)

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“…No new cases developed after these measures were instituted. Another outbreak of four cases of influenza A occurred in an outpatient residential facility for BMT patients [83]. Oseltamivir prophylaxis was given to 45 patients.…”

Section: Primary Chemoprophylaxismentioning

confidence: 99%

Protecting Pediatric Oncology Patients From Influenza

et al. 2013

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Influenza is a common respiratory pathogen. Its severity can be unpredictable, but people with chronic illness are at increased risk of severe infection, complications, and death from influenza. This review examines evidence to support various strategies to protect pediatric oncology patients from influenza-related morbidity. Influenza vaccination should be considered standard. Additional evidence-supported measures include antiviral treatment, antiviral prophylaxis, cohorting of patients, and hospital infection control measures. Data from other high-risk populations support the vaccination of family members, double-dose or high-dose vaccination, and the use of barrier methods. These measures have the potential to optimize patient outcomes because there will be fewer treatment interruptions for acute illness. These strategies can also protect patients from prolonged hospitalizations and morbidity related to influenza. The Oncologist 2013;18:204 -211 Implications for Practice: Pediatric oncology patients can have very severe infections with the influenza virus. Their vulnerability is due to chronic illness and immune suppression. Simple strategies, such as ensuring vaccination, infection control measures, and education regarding personal protection can protect this population that is susceptible to severe influenza.

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Section: Primary Chemoprophylaxismentioning

confidence: 99%

Protecting Pediatric Oncology Patients From Influenza

et al. 2013

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“…Antiviral prophylaxis given to all patients at risk during a community or institutional outbreak is another option. 94 Initial results from a randomized trial in mildly to moderately immunosuppressed (mainly solid organ) transplant recipients has been presented 95 and suggests a beneficial effect for laboratoryconfirmed seasonal influenza with little drug resistance. Whether such approach is effective without increased emergence of resistance in severely immunocompromised patients with the current pandemic strain is unknown, although resistance has been described even in normal hosts receiving prophylaxis.…”

Section: Infection Controlmentioning

confidence: 99%

“…Such a strategy has been successfully used in a seasonal influenza outbreak at an outpatient living facility. 94 The 2008 global HC transplantation infection prevention guidelines endorse the use of antiviral prophylaxis during community outbreaks that lead to nosocomial transmission. 58 …”

Section: Infection Controlmentioning

confidence: 99%

How I treat influenza in patients with hematologic malignancies

Casper

Englund

Boeckh

2010

Blood

119

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“…The prophylactic and therapeutic efficacy of antiviral agents in SOT and HSCT recipients with influenza has been shown in case series [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Transplant Recipients Who Developed Influenza in 2007-08 Despite Influenza Vaccination

Mossad

Yen‐Lieberman

Shrestha

et al. 2013

J Vaccines Vaccin 2013

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Background: Influenza vaccination may be less immunogenic in transplant recipients than in healthy people. Influenza A (H1N1) and B circulating viruses during the 2007-2008 epidemic were different from those contained in that season's vaccine. In that epidemic, influenza vaccine effectiveness against culture-confirmed influenza was 44%.Objective: To describe clinical, immunological, and virological characteristics of 18 transplant recipients who developed influenza during the 2007-08 epidemic despite influenza vaccination (tx-vac-flu), and compare them to 6 transplant recipients who developed influenza in the absence of influenza vaccination (tx-no vac-flu), 12 previously healthy people who developed influenza (healthy-flu), and 13 transplant recipients who received influenza vaccination and did not develop influenza (tx-vac-no flu). Methods:Case ascertainment was through microbiology and electronic medical records. A case of influenza was defined by a clinical presentation of an influenza-like illness, plus a positive influenza A or B multiplex real time polymerase chain reaction (Prodesse, Inc. Waukesha, WI) on a nasopharyngeal swab. Results:Of the 36 patients with influenza, 22 had influenza A, and 15 had influenza B (1 transplant recipient had both serotypes simultaneously). Types of transplant were lung (11), hematopoietic stem cell (8), heart (7), liver (3), kidney (3), kidney + pancreas Immunoglobulin G levels and immune function assay levels were not significantly different between the 3 transplant groups. There were no statistically significant differences in the incidence of fever, headache, cough, rhinorrhea, sore throat, malaise, shortness of breath, exposure to contacts with similar symptoms, presence of infiltrates on chest roentgenograms, or the estimated influenza viral loads among the 3 groups who had influenza. Patients in the tx-vac-flu group were treated with oseltamivir significantly more frequently than the healthy-flu group [94% vs. 50% (P=0.0006)], but not the tx-no vac-flu group [100% (P=0.7)]. Duration of treatment with oseltamivir was not significantly different among the 3 groups who had influenza. Patients in the tx-vac-flu group had concomitant infections significantly more frequently than the healthy-flu group [44% vs. 8% (P=0.043)], but not the tx-no vac-flu group. Patients in the tx-vac-flu group developed pneumonia, and were hospitalized for management of influenza significantly more frequently than patients in the healthy-flu group (P=0.031 and P=0.00007; respectively). Only one patient (6%) in the tx-vac-flu group and none in the tx-no vac-flu or healthy-flu groups required admission to an intensive care unit and mechanical ventilation following influenza. No patients died as a result of influenza.Conclusions: Influenza vaccination did not alter clinical presentation of influenza in transplant recipients, but these patients were hospitalized and developed pneumonia more frequently than healthy people. Transplant recipients who developed influenza despite influenza vacc...

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Safety and Tolerability of Oseltamivir Prophylaxis in Hematopoietic Stem Cell Transplant Recipients: A Retrospective Case-Control Study

Abstract: Oseltamivir prophylaxis appeared to be safe and well tolerated in managing an influenza outbreak in an HSCT outpatient residence.

Cited by 80 publications

References 16 publications

Protecting Pediatric Oncology Patients From Influenza

Protecting Pediatric Oncology Patients From Influenza

How I treat influenza in patients with hematologic malignancies

Characteristics of Transplant Recipients Who Developed Influenza in 2007-08 Despite Influenza Vaccination

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