Abstract
Community-acquired respiratory virus infections are a cause of mortality after stem cell transplantation (SCT). A prospective study was performed at 37 centers to determine their frequency and importance. Additional cases were also collected to allow the analysis of risk factors for severe infection. Forty episodes were collected in the prospective study and 53 additional episodes through subsequent case collection. The frequency of documented respiratory virus infections was 3.5% among 819 allogeneic and 0.4% among 1154 autologous SCT patients transplanted during the study period. The frequency of lower respiratory tract infections (LRTI) was 2.1% among allogeneic and 0.2% among autologous SCT patients. The mortality within 28 days from diagnosis of a respiratory viral infection was 1.1% among allogeneic SCT while no autologous SCT patient died. The deaths of five patients (0.6%) were directly attributed to a respiratory virus infection (three RSV; two influenza A). On multivariate analysis, lymphocytopenia increased the risk for LRTI (P = 0.008). Lymphocytopenia was also a significant risk factor for LRTI in patients with RSV infections. The overall mortality in RSV infection was 30.4% and the direct RSV-associated mortality was 17.4%. For influenza A virus infection, the corresponding percentages were 23.0% and 15.3%. This prospective study supports the fact that community-acquired respiratory virus infections cause transplant-related mortality after SCT. Bone Marrow Transplantation (2001) 28, 479–484.
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Acknowledgements
We are grateful to the investigators who contributed to this study: P Shaw, New Children's Hospital; Sydney; AP Schwarer, Alfred Hospital, Melbourne, Australia; HJ Dornbusch, University Children's Hospital, Graz; C Peters, St Anna Kinderspital, Vienna, Austria; A Ferrant, Cliniques Universitaires St Luc, Brussels; W Feremans, Hopital Erasme, Brussels; D Selleslag, AZ Sint-Jan, Brugge, Belgium; A Vitek, Institute of Hematology and Blood Transfusion, Prague, Czech Republic; L Volin, University Hospital, Helsinki; E Koivunen, Tampere University Hospital, Tampere, Finland; C Cordonnier, Hôpital Henri Mondor, Creteil, France; R Arnold, Universitätsklinikum Charité; W Knauf, Klinikum Benjamin Franklin, Berlin; U Duffner, Universitäts-kinderklinik, Freiburg; W Kruger; University Hospital, Hamburg-Eppendorf; AA Fauser, University Hospital, Idar Oberstein; F Zintl, Friedrich-Schiller Universität, Jena, Germany; A Bosi, University Hospital, Florence; F Patrone, University of Genova, Genova; G Lambertenghi-Deliliers, Ospedale Maggiore, Milan; EP Alessandrino, Policlinico S Matteo, Pavia; P Bavaro, Ospedale Civile, Pescara, Italy; A Dekker, University Hospital, Utrecht, The Netherlands; L Brinch, Rikshospitalet, Oslo; H Holte, Norwegian Radium Hospital, Oslo, Norway; H Mocikova, Roosevelt Hospital, Banská Bystrica, Slovakia; R Martino, Hospital Santa Creu i Sant Pau, Barcelona; R De La Camara, Hospital de la Princesa, Madrid; D Caballero, University Hospital, Salamanca, Spain; P Ljungman, Huddinge University Hospital, Stockholm; M Brune, Sahlgren's Hospital, Gothenburg; K Pauksen, K Carlsson, Uppsala University Hospital, Uppsala; U Tidefelt, Örebro Hospital, Örebro, Sweden; D Milligan, Birmingham Heartlands Hospital, Birmingham; D Spence, HCI International Medical Center, Clydebank; A Parker, Glasgow Royal Infirmary, Glasgow; S Schey, Guys Hospital, London; KN Ward, Hammersmith Hospital, London; B Crooks, Newcastle General Hospital; G Jackson, R Skinner, Royal Victoria Infirmary, Newcastle upon Tyne; N Russell, Nottingham; P Lorigan, Weston Park Hospital, Sheffield, UK.
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Ljungman, P., Ward, K., Crooks, B. et al. Respiratory virus infections after stem cell transplantation: a prospective study from the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 28, 479–484 (2001). https://doi.org/10.1038/sj.bmt.1703139
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DOI: https://doi.org/10.1038/sj.bmt.1703139
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