Upper Respiratory Viral Infections in Patients with Haematological Malignancies after Allogeneic Haematopoietic Stem Cell Transplantation: A Retrospective Study

Autor: Didem Sahin, Muhit Ozcan, Sinem Civriz Bozdag, Osman Ilhan, Pinar Ataca Atilla, Pervin Topcuoglu, Istar Dolapci, Meltem Kurt Yuksel, Onder Arslan, Gunhan Gurman, Alper Tekeli, Erden Atilla, Selami Kocak Toprak
Rok vydání: 2017
Předmět:
Adult
Male
0301 basic medicine
medicine.medical_specialty
medicine.medical_treatment
Pneumonia
Viral
Respiratory Syncytial Virus Infections
Hematopoietic stem cell transplantation
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Humans
Transplantation
Homologous
Medicine
Pharmacology (medical)
Lymphocyte Count
Respiratory system
Prospective cohort study
Respiratory Tract Infections
Aged
Retrospective Studies
Pharmacology
Paramyxoviridae Infections
business.industry
Respiratory disease
Hematopoietic Stem Cell Transplantation
Retrospective cohort study
Middle Aged
medicine.disease
Survival Analysis
Transplantation
Pneumonia
C-Reactive Protein
030104 developmental biology
Infectious Diseases
Hematologic Neoplasms
Respiratory Syncytial Virus
Human
Concomitant
Paramyxoviridae
Female
business
030215 immunology
Zdroj: Antiviral Therapy. 23:523-527
ISSN: 2040-2058
1359-6535
DOI: 10.3851/imp3224
Popis: Background Community respiratory viruses (CRVs) are associated with upper respiratory viral infections (URI), pneumonia or life-threatening respiratory disease in patients with allogeneic haematopoietic stem cell transplantation (allo-HSCT). Our aim is to demonstrate our URI experience related to CRVs after allo-HSCT. Methods From January 2013 to November 2015, 39 post allo-HSCT patients with acute URI symptoms were included in the study. We evaluated CRVs by multiplex PCR from nasopharyngeal wash and throat swabs. Results The median age of the patients was 39 (range 20–67 years). A total of 25 patients (64%) had viral panel positivity at a median 140 days post-transplant (range 3–617 days). The most common agents detected were respiratory syncytial virus (32%) and parainfluenza (32%). The patients with viral panel positivity had significantly lower lymphocyte count (1.05x109/l versus 3.09x109/l; P=0.013). During follow-up, 20 patients (80%) were diagnosed with pneumonia. Patients with concurrent bacterial or fungal infections were more likely to have pneumonia (100% versus 68%; P=0.023). 10 patients (40%) died due to pneumonia and related complications. Lower lymphocyte counts and higher C-reactive protein levels at the time of viral panel positivity were risk factors for mortality (1.5x109/l versus 0.39x109/l, P=0.007; 74.2 versus 199.7, P=0.006). Conclusions The viral panel was positive in 64% of patients with acute URI symptoms. Lower lymphocyte count was detected in CRV-positive patients. The onset of concomitant bacterial or fungal infections increased the risk of lower respiratory infection disease. Indeed, prospective studies should be designed for risks and outcomes of CRVs in allo-HSCT recipients.
Databáze: OpenAIRE
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