Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2016 Mar;22(3):542-8.
doi: 10.1016/j.bbmt.2015.11.015. Epub 2015 Nov 27.

Outcomes of Influenza Infections in Hematopoietic Cell Transplant Recipients: Application of an Immunodeficiency Scoring Index

Joumana Kmeid  1 , Jakapat Vanichanan  1 , Dimpy P Shah  1 , Firas El Chaer  1 , Jacques Azzi  1 , Ella J Ariza-Heredia  1 , Chitra Hosing  2 , Victor Mulanovich  1 , Roy F Chemaly  3
Affiliations
Clinical Trial

Outcomes of Influenza Infections in Hematopoietic Cell Transplant Recipients: Application of an Immunodeficiency Scoring Index

Joumana Kmeid et al. Biol Blood Marrow Transplant. 2016 Mar.

Abstract

Hematopoietic cell transplant (HCT) recipients have lower immune response to influenza vaccination and are susceptible to lower respiratory tract infection (LRI) and death. We determined clinical characteristics and outcomes of laboratory-confirmed influenza, including 2014/H3N2 infection, in 146 HCT recipients. An immunodeficiency scoring index (ISI) was applied to identify patients at high risk for LRI and death. Thirty-three patients (23%) developed LRI and 7 (5%) died within 30 days of diagnosis. Most patients received antiviral therapy (83%); however, only 18% received it within 48 hours of symptom onset. The incidence of LRI was significantly higher in the ISI high-risk group than it was in the low-risk group (P < .001). Receiving early antiviral therapy was associated with a substantial reduction in LRI for all ISI risk groups with the greatest risk reduction observed in the high-risk group. When compared with previous seasons, no significant differences in patient outcomes were observed during the 2014/H3N2 season; however, antiviral therapy was more promptly initiated in the latter season. The ISI that was originally developed for respiratory syncytial virus may help identify HCT recipients at risk for progression to LRI and mortality after influenza infection. These patients should be monitored more closely. Early initiation of antiviral therapy for influenza in HCT recipients, regardless of the ISI risk group, may improve morbidity as well as mortality.

Keywords: Antiviral therapy; Cancer; Immunocompromised; Influenza; Scoring index.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Symptom Profile for Patients with Influenza Infection.
Figure 2
Figure 2
Kaplan-Meier Failure Curves for LRI incidence, stratified by ISI risk groups and early antiviral therapy.
See this image and copyright information in PMC

References

    1. (CDC) CfDCaP. Update: Influenza Activity-United States, 2009–10 season. 2010. pp. 901–908. - PubMed
    1. Shrestha SS, Swerdlow DL, Borse RH, Prabhu VS, Finelli L, Atkins CY, et al. Estimating the burden of 2009 pandemic influenza A (H1N1) in the United States (April 2009-April 2010) Clin Infect Dis. 2011;52(Suppl 1):S75–82. - PubMed
    1. Jain S, Kamimoto L, Bramley AM, Schmitz 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(20):1935–1944. - PubMed
    1. Shah DP, El Taoum KK, Shah JN, Vigil KJ, Adachi JA, Granwehr BP, et al. Characteristics and outcomes of pandemic 2009/H1N1 versus seasonal influenza in children with cancer. Pediatr Infect Dis J. 2012;31(4):373–378. - PubMed
    1. Chemaly RF, Vigil KJ, Saad M, Vilar-Compte D, Cornejo-Juarez P, Perez-Jimenez C, et al. A multicenter study of pandemic influenza A (H1N1) infection in patients with solid tumors in 3 countries: early therapy improves outcomes. Cancer. 2012;118(18):4627–4633. - PubMed

Publication types