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Upper and/or Lower Respiratory Tract Infection Caused by Human Metapneumovirus After Allogeneic Hematopoietic Stem Cell Transplantation.

Authors :
Piñana, Jose Luis
Tridello, Gloria
Xhaard, Aliénor
Wendel, Lotus
Montoro, Juan
Vazquez, Lourdes
Heras, Inmaculada
Ljungman, Per
Mikulska, Malgorzata
Salmenniemi, Urpu
Perez, Ariadna
Kröger, Nicolaus
Cornelissen, Jan
Sala, Elisa
Martino, Rodrigo
Geurten, Claire
Byrne, Jenny
Maertens, Johan
Kerre, Tessa
Martin, Murray
Source :
Journal of Infectious Diseases. 1/15/2024, Vol. 229 Issue 1, p83-94. 12p.
Publication Year :
2024

Abstract

Background Human metapneumovirus (hMPV) epidemiology, clinical characteristics and risk factors for poor outcome after allogeneic stem cell transplantation (allo-HCT) remain a poorly investigated area. Methods This retrospective multicenter cohort study examined the epidemiology, clinical characteristics, and risk factors for poor outcomes associated with human metapneumovirus (hMPV) infections in recipients of allo-HCT. Results We included 428 allo-HCT recipients who developed 438 hMPV infection episodes between January 2012 and January 2019. Most recipients were adults (93%). hMPV infections were diagnosed at a median of 373 days after allo-HCT. The infections were categorized as upper respiratory tract disease (URTD) or lower respiratory tract disease (LRTD), with 60% and 40% of cases, respectively. Patients with hMPV LRTD experienced the infection earlier in the transplant course and had higher rates of lymphopenia, neutropenia, corticosteroid use, and ribavirin therapy. Multivariate analysis identified lymphopenia and corticosteroid use (>30 mg/d) as independent risk factors for LRTD occurrence. The overall mortality at day 30 after hMPV detection was 2% for URTD, 12% for possible LRTD, and 21% for proven LRTD. Lymphopenia was the only independent risk factor associated with day 30 mortality in LRTD cases. Conclusions These findings highlight the significance of lymphopenia and corticosteroid use in the development and severity of hMPV infections after allo-HCT, with lymphopenia being a predictor of higher mortality in LRTD cases. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00221899
Volume :
229
Issue :
1
Database :
Academic Search Index
Journal :
Journal of Infectious Diseases
Publication Type :
Academic Journal
Accession number :
174783566
Full Text :
https://doi.org/10.1093/infdis/jiad268