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. 2006 Jun 15;193(12):1619-25.
doi: 10.1086/504268. Epub 2006 May 10.

Airflow decline after myeloablative allogeneic hematopoietic cell transplantation: the role of community respiratory viruses

Veronique Erard  1 , Jason W Chien, Hyung W Kim, W Garrett Nichols, Mary E Flowers, Paul J Martin, Lawrence Corey, Michael Boeckh
Affiliations

Airflow decline after myeloablative allogeneic hematopoietic cell transplantation: the role of community respiratory viruses

Veronique Erard et al. J Infect Dis. .

Abstract

We conducted a 12-year retrospective study to determine the effects that the community respiratory-virus species and the localization of respiratory-tract virus infection have on severe airflow decline, a serious and fatal complication occurring after hematopoietic cell transplantation (HCT). Of 132 HCT recipients with respiratory-tract virus infection during the initial 100 days after HCT, 50 (38%) developed airflow decline < or =1 year after HCT. Lower-respiratory-tract infection with parainfluenza (odds ratio [OR], 17.9 [95% confidence interval {CI}, 2.0-160]; P=.01) and respiratory syncytial virus (OR, 3.6 [95% CI, 1.0-13]; P=.05) independently increased the risk of development of airflow decline < or =1 year after HCT. The airflow decline was immediately detectable after infection and was strongest for lower-respiratory-tract infection with parainfluenza virus; it stabilized during the months after the respiratory-tract virus infection, but, at < or =1 year after HCT, the initial lung function was not restored. Thus, community respiratory virus-associated airflow decline seems to be specific to viral species and infection localization.

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Figures

Table 1
Table 1
Clinical characteristics of the study population
Table 2
Table 2
Distribution of severe airflow decline by 1 year after hematopoietic stem cell transplantation, for different categories of respiratory-tract virus infection
Table 3
Table 3
Risk of severe airflow decline by 1 year after hematopoietic stem cell transplantation, according to virus species and localization of respiratory infection
Figure 1
Figure 1
Annualized rates of decline in percentage of predicted first-1-s forced expiratory volume (FEV1), for each category of respiratory-tract infection, from baseline to day 100 (A) and from day 100 to year 1 (B). Nos. below the graph denote the no. of patients evaluated by pulmonary function tests at day 100 (A) and at year 1 (B). Other categories are infection with adenovirus (n=9), rhinovirus (n=2), or influenzavirus A and B (n=18). Para-L, lower respiratory tract (LRT) parainfluenza-virus infection; Para-U, upper respiratory tract (URT) parainfluenza-virus infection; RSV-L, LRT respiratory syncytial virus infection; RSV-U, URT respiratory syncytial virus infection
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References

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