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Post-Transplant Events

Evaluation of a surveillance strategy for early detection of adenovirus by PCR of peripheral blood in hematopoietic SCT recipients: incidence and outcome

Bone Marrow Transplantation volume 46, pages 267–272 (2011)Cite this article

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Abstract

Adenoviruses (AdV) have emerged as important causes of morbidity and mortality in patients after hematopoietic SCT (HSCT). Early diagnosis of the infection by detection of viral DNA may improve the prognosis. A surveillance strategy was evaluated for detection of AdV DNA by PCR in a prospective study of unselected allogeneic HSCT recipients. In parallel with a routine CMV surveillance program, plasma from 20 children and 77 adults was analyzed by quantitative PCR for detection of AdV DNA. In addition, in 12 unselected patients, the presence of AdV-specific T cells were analyzed by enzyme-linked immunosorbent spot (ELISPOT) at 1 to 3 months after transplantation. A total of 5 of 97 (5%) patients had detectable AdV DNA in peripheral blood. Only one patient had high titers and none developed AdV disease. BM as a source of stem cells and myelodysplastic syndrome as the indication for transplantation were independently associated with higher risk of acquiring AdV infection. AdV-specific T cells were detected in 7 (58%) of 12 patients. Although AdV DNA was found in peripheral blood by quantitative PCR in 5% of patients undergoing allogeneic HSCT, the present surveillance program did not have a significant effect on the clinical outcome.

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Acknowledgements

We thank all patients, including guardians, for their involvement in the study. We are indebted to Karin Fransson and the staff of the SCT units for their dedication to the study and collection of specimens. We acknowledge the technical and scientific contributions of Annika Allard at the clinical virological laboratory at Umeå University Hospital, Sweden, and the staff at the virological laboratory at Karolinska University Hospital, Huddinge, Sweden. Grants were received from the Stockholm City Council/Karolinska Institutet and from the Swedish Children's Cancer Foundation.

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Author notes

  1. L Öhrmalm and A Lindblom: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

    L Öhrmalm, A Lindblom, O Norbeck, I Gustafson & K Broliden

  2. Department of Medicine, Division of Hematology, Huddinge, Karolinska Institutet, Stockholm, Sweden

    H Omar & P Ljungman

  3. Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

    I Lewensohn-Fuchs

  4. Department of Hematology, University of Gothenburg, Gothenburg, Sweden

    J-E Johansson & M Brune

  5. Hematology Centre, Karolinska University Hospital, Stockholm, Sweden

    P Ljungman

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  1. L Öhrmalm
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  2. A Lindblom
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Correspondence to L Öhrmalm.

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Öhrmalm, L., Lindblom, A., Omar, H. et al. Evaluation of a surveillance strategy for early detection of adenovirus by PCR of peripheral blood in hematopoietic SCT recipients: incidence and outcome. Bone Marrow Transplant 46, 267–272 (2011). https://doi.org/10.1038/bmt.2010.86

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