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Microbial Issues

Adenoviral infections in adult allogeneic hematopoietic SCT recipients: a single center experience

Bone Marrow Transplantation volume 48, pages 1218–1223 (2013)Cite this article

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Abstract

Disseminated adenoviral infection (AI) is associated with profound immunosuppression and poor outcome after allogeneic hematopoietic SCT (allo-HSCT). A better understanding of AI in allo-HSCT recipients can serve as a basis to develop more effective management strategies. We evaluated all adult patients who received allo-HSCT at MD Anderson Cancer Center between 1999 and 2008. Among the 2879 allo-HSCT patients, 73 (2.5%) were diagnosed with AI. Enteritis (26%) and pneumonia (24%) were the most common clinical manifestations; pneumonia was the most common cause of adenovirus-associated death. A multivariable Bayesian logistic regression showed that when the joint effects of all covariates were accounted for, cord blood transplant, absolute lymphocyte count (ALC) ⩽200/mm3 and male gender were associated with a higher probability of disseminated AI. The OS was significantly worse for patients with AI that was disseminated rather than localized (median of 5 months vs median of 28 months, P<0.001) and for patients with ALC ⩽200/mm3 (P<0.001). Disseminated AI, in patients who received allo-HSCT, is a significant cause of morbidity and mortality. Strategies for early diagnosis and intervention are essential, especially for high-risk patients.

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Acknowledgements

This work was supported in part by the Cancer Center Support Grant (NCI Grant P30 CA016672).

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Authors and Affiliations

  1. Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    M Yilmaz

  2. Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    R F Chemaly

  3. Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    X Y Han & J J Tarrand

  4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    P F Thall & P S Fox

  5. Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    M J De Lima, C M Hosing, U R Popat, E Shpall, R E Champlin & M H Qazilbash

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Correspondence to M H Qazilbash.

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Yilmaz, M., Chemaly, R., Han, X. et al. Adenoviral infections in adult allogeneic hematopoietic SCT recipients: a single center experience. Bone Marrow Transplant 48, 1218–1223 (2013). https://doi.org/10.1038/bmt.2013.33

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