Viral respiratory infections diagnosed by multiplex PCR after allogeneic hematopoietic stem cell transplantation: long-term incidence and outcome

Abstract

Viral respiratory infections (VRIs) are frequent after hematopoietic stem cell transplantation and constitute a potential cause of mortality. We analyzed the incidence, risk factors, and prognosis of VRIs in a cohort of transplanted patients. More frequent viruses were human coronavirus and human rhinovirus followed by flu-like viruses and adenovirus. Risk factors for death were lymphocytopenia and high steroid dosage.

Keywords: Allogeneic hematopoietic stem cell transplantation; Respiratory viral infections.

Figure 1

Cumulative incidence of VRI and mortality within 3 months after VRI. (A) Cumulative incidence of first VRI from any virus, the shaded region represents the pointwise 95% confidence interval. (B) Cumulative incidence of first VRI by each of 3 virus categories. (C) Mortality incidence according to virus group: AdV, HCoR and HRV, and flu-like. (D) Mortality incidence according to steroid dose. (E) Mortality incidence according to lymphocyte count. (F) Mortality incidence according to copathogen presence. Infections with different viruses found at the same time or at different times in a same patient were all analyzed, although only the first virus of each group was considered. Because this yields to clustering, data were analyzed using generalized estimating equations with a robust variance estimator.