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Impact of parainfluenza virus type 3 infection on engraftment after hematopoietic SCT

Bone Marrow Transplantation volume 47, pages 451–452 (2012)Cite this article

Human parainfluenza virus type 3 (PIV3) can cause severe morbidity and mortality among haematopoietic stem cell transplant (HSCT) recipients.1, 2 In fact, studies have reported mortality rates of up to 40–50% in adult HSCT patients with PIV3-related pneumonia.3 Previous reports, however, have focussed almost entirely on the pulmonary manifestations of PIV3 infection in the HSCT population.4 Extra-pulmonary manifestations of PIV3 infection are rare, but can include meningitis, myopericarditis and parotitis.5 We report here a nosocomial outbreak of PIV3 involving HSCT recipients, and describe associated haematologic manifestations, including loss of engraftment in severely affected patients.

To conclude, in this series, patients with mild to moderate respiratory symptoms secondary to PIV3 infection did not manifest significant cytopenias. However, three of the most severely affected patients experienced profound cytopenias, with loss of engraftment in two of the three. The timing of PIV3 infection in relation to hematopoietic engraftment may be a contributing factor. To our knowledge, severe hematological manifestations of PIV3 infection have not been reported previously. Similar findings have been described in association with respiratory syncytial virus infection in HSCT recipients. In one series, two patients autografted for multiple myeloma showed delayed neutrophil and platelet engraftment after respiratory syncytial virus infection. A third patient, who received an HLA-matched allograft for relapsed multiple myeloma, experienced secondary graft failure shortly after respiratory syncytial virus infection.6 In addition, there are two case reports in the literature of secondary graft failure following PIV1 infection in pediatric HSCT recipients.7 Hence, this case series highlights the importance of infection control practices on hospital wards with HSCT recipients, and identifies a potentially under-recognized but important complication of HSCT.

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Authors and Affiliations

  1. Department of Medicine, Division of Hematology, University of Ottawa, Ontario, Canada

    M Toupin & D S Allan

  2. The Ottawa Hospital Blood & Marrow Transplant Program, Ontario, Canada

    A Hamadah, S Madore & D S Allan

  3. Department of Pathology, University of Ottawa, Ontario, Canada

    R Padmore

Authors
  1. M Toupin
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  2. A Hamadah
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  3. S Madore
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  4. R Padmore
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  5. D S Allan
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Correspondence to D S Allan.

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Toupin, M., Hamadah, A., Madore, S. et al. Impact of parainfluenza virus type 3 infection on engraftment after hematopoietic SCT. Bone Marrow Transplant 47, 451–452 (2012). https://doi.org/10.1038/bmt.2011.85

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