Abstract
The clinical course of 2009 H1N1 influenza in Allo-SCT patients is unknown. Data were collected in the UK from October 2009 to April 2010 on laboratory-confirmed cases of H1N1 influenza in Allo-SCT recipients. H1N1 infection was diagnosed in 60 patients, median age 42 years, at a median of 10 months post-SCT. Twenty-one patients (35%) developed pneumonia and nine (15%) required admission to intensive care units. Actuarial mortality was 7% at 28 days and 19% 4 months post-diagnosis of 2009 H1N1 influenza. Increasing age and pre-existing lung disease were risk factors for pneumonia (P=0.006 and 0.037, respectively); older age was a risk factor for death (P=0.012). Morbidity and mortality from 2009 H1N1 influenza in SCT patients exceeds that of immunocompetent patients, but parallels that in other critically ill hospitalised cohorts; the elderly and those with chronic pulmonary disease are at greatest risk.
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References
WHO. WHO Director-General Dr Margaret Chan's Press Conference, 11th June 2009. http://www.who.int/mediacentre/influenzaAH1N1_presstranscript_20090611.pdf (accessed 6 May 2010).
WHO. Pandemic (H1N1) 2009—Update 112. http://www.who.int/csr/don/2010_08_06/en/index.html (accessed 20 December 2010).
Couch RB, Englund JA, Whimbey E . Respiratory viral infections in immunocompetent and immunocompromised persons. Am J Med 1997; 102: 2–9.
Ljungman P . Respiratory virus infections in bone marrow transplant recipients: the European perspective. Am J Med 1997; 102: 44–47.
Ljungman P . Respiratory virus infections in stem cell transplant patients: the European experience. Biol Blood Marrow Transplant 2001; 7: 5S–7S.
Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J, Lacroix J et al. Critically ill patients with 2009 influenza A (H1N1) infection in Canada. JAMA 2009; 302: 1872–1879.
Louie JK, Acosta M, Winter K, Jean C, Gavali S, Schechter R et al. Factors associated with death or hospitalization due to pandemic 2009 influenza A (H1N1) infection in California. JAMA 2009; 302: 1896–1902.
Camous L, Lemiale V, Canet E, Max A, Schnell D, Le Goff J et al. Clinical features of H1N1 2009 infection in critically ill immunocompromised patients. Crit Care 2010; 14: 139.
Lapinsky SE . H1N1 novel influenza A in pregnant and immunocompromised patients. Crit Care Med 2010; 38S: e52–e57.
WHO. Human infection with pandemic (H1N1) 2009 virus: updated interim WHO guidance on global surveillance. http://www.who.int/csr/disease/swineflu/WHO_case_definition_swine_flu_2009_04_29.pdf (accessed 1 June 2010).
Johnny AA, Clark A, Price N, Carrington D, Oakhill A, Marks D . Zanamivir for treatment of influenza A and B infections following stem cell transplantation. Bone Marrow Transplant 2002; 29: 113–115.
Hassan IA, Chopra R, Swindell R, Mutton KJ . Respiratory viral infections after bone marrow/peripheral stem cell transplantation: the Christie hospital experience. Bone Marrow Transplant 2003; 32: 73–77.
Machado CM, Boas LS, Mendes AV, Santos MF, da Rocha IF, Sturaro D et al. Low mortality rates related to respiratory virus infections after bone marrow transplantation. Bone Marrow Transplant 2003; 31: 695–700.
Nichols MG, Guthrie KA, Corey L, Boeckh M . Influenza infections after haematopoietic stem cell transplantation: risk factors, mortality, and the effect of antiviral therapy. Clin Infect Dis 2004; 39: 1300–1306.
Boechk M . The challenge of respiratory virus infections in hematopoietic stem cell transplant recipients. Br J Haematol 2008; 143: 455–467.
Redelman-Sidi G, Sepkowitz KA, Huang CK, Park S, Stiles J, Eagan J et al. 2009 H1N1 influenza infection in cancer patients and haematopoietic stem cell transplant recipients. J Infect 2010; 60: 257–263.
Taplitz R, Espinosa-Arguilar L, Green J, Forrest G, Ball E, Maziarz R et al. Novel H1N1 Influenza in haematopoietic stem cell transplant recipients: two center's experience. Biol Blood Marrow Transplant (e-pub ahead of print 12 August 2010; doi:10.1016/j.bbmt.2010.07.018).
Lalayanni C, Sirigou A, Iskas M, Smias C, Sakellari I, Anagnostopoulos A . Outbreak of novel influenza A (H1N1) in a n adult haematology department and haematopoietic cell transplantation unit: clinical presentation and outcome. J Infect 2010; 61: 270–272.
Cortes JMM, Gomez LP, Morilla EP, Garcia VG, Pla ED, Merino JCF et al. Behaviour of the pandemic H1N1 influenza virus in Andalusia, Spain, at the onset of the 2009–10 season. Euro Surveill 2009; 14: pii=19433; http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19433: (accessed 13 May 2010).
Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ et al. Emergence of a Novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009; 360: 2605–2615.
Komiya N, Gu Y, Kamiya H, Yahata Y, Matsui T, Yasui Y et al. Clinical features of cases of influenza A (H1N1)V in Osaka Prefecture, Japan, May 2009. Euro Surveill 2009; 14: pii=19272; http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19272 (accessed 13 May 2010).
Donaldson LJ, Rutter PD, Ellis BM, Greaves FEC, Mytton OT, Pebody RG et al. Mortality from pandemic A/H1N1 2009 influenza in England: public health surveillance study. BMJ 2009; 339: b5213.
Department of Health. Pandemic H1N1 2009 Influenza: Clinical Management Guidelines for Adults and Children. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_107769 (accessed 14 June 2010).
Jain S, Kaminoto L, Bramley A, Scmitz AM, Benoit SR, Louie J et al. Hospitalized patients with 2009 H1N1 influenza in the United States, April–June 2009. N Engl J Med 2009; 361: 1935–1944.
Campbell A, Rodin R, Kropp R, Mao Y, Hong Z, Vachon J et al. Risk of severe outcomes among patients admitted to hospital with pandemic (H1N1) influenza. CMAJ 2010; 182: 349–355.
Bautista E, Chotpitayasunondh T, Goa Z, Harper SA, Shaw M, Uyeki TM et al. Clinical aspects of pandemic 2009 influenza (H1N1) virus infection. N Engl J Med 2010; 362: 1708–1719.
Cate TR, Kasel JA, Couch RB, Six HR, Knight V . Clinical trials of bivalent influenza A/New Jersey/76-A/Victoria/75 vaccines in the elderly. J Infect Dis 1977; 136: S518–S525.
Peck AJ, Englund JA, Kuypers J, Guthrie KA, Corey L, Morrow R et al. Respiratory virus infection among hematopoietic stem cell transplant recipients. Blood 2007; 110: 1681–1688.
Kumar D, Michaels MG, Morris MI, Green M, Avery RK, Lui C et al. Outcomes from pandemic influenza A H1N1 infection in recipients of solid-organ transplants: a multicentre cohort study. Lancet Infect Dis 2010; 10: 521–526.
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We thank the data managers and transplant physicians at participating centres for providing data.
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Protheroe, R., Kirkland, K., Pearce, R. et al. The clinical features and outcome of 2009 H1N1 influenza infection in allo-SCT patients: a British Society of Blood and Marrow Transplantation study. Bone Marrow Transplant 47, 88–94 (2012). https://doi.org/10.1038/bmt.2011.12
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DOI: https://doi.org/10.1038/bmt.2011.12