The impact of RSV, adenovirus, influenza, and parainfluenza infection in pediatric patients receiving stem cell transplant, solid organ transplant, or cancer chemotherapy

Mindy S Lo; Grace M Lee; Nilanthi Gunawardane; Sandra K Burchett; Catherine S Lachenauer; Leslie E Lehmann

doi:10.1111/petr.12022

The impact of RSV, adenovirus, influenza, and parainfluenza infection in pediatric patients receiving stem cell transplant, solid organ transplant, or cancer chemotherapy

Pediatr Transplant. 2013 Mar;17(2):133-43. doi: 10.1111/petr.12022. Epub 2012 Dec 10.

Authors

Mindy S Lo¹, Grace M Lee, Nilanthi Gunawardane, Sandra K Burchett, Catherine S Lachenauer, Leslie E Lehmann

Affiliation

¹ Division of Immunology, Department of Medicine, Boston Children's Hospital, Boston, MA, USA.

PMID: 23228170
DOI: 10.1111/petr.12022

Abstract

RVIs are a significant cause of morbidity and mortality in immunocompromised children. We analyzed the characteristics and outcomes of infection by four respiratory viruses (RSV, adenovirus, influenza, and parainfluenza) treated at a pediatric tertiary care hospital in a retrospective cohort of patients who had received cancer chemotherapy, hematopoietic stem cell, or SOT. A total of 208 infections were studied among 166 unique patients over a time period of 1993-2006 for transplant recipients, and 2000-2005 for patients with cancer. RSV was the most common respiratory virus identified. There were 17 (10% of all patients) deaths overall, of which 12 were at least partly attributed to the presence of a RVI. In multivariate models, LRT symptoms in the absence of upper respiratory symptoms on presentation (OR 10.2 [2.3, 45.7], p = 0.002) and adenoviral infection (OR 3.7 [1.1, 12.6], p = 0.034) were significantly associated with poor outcome, defined as death or disability related to RVI. All of the deaths occurred in patients who had received either solid organ or HSCT. There were no infections resulting in death or disability in the cancer chemotherapy group.

Publication types

Evaluation Study

MeSH terms

Adenovirus Infections, Human / drug therapy
Adenovirus Infections, Human / immunology
Adenovirus Infections, Human / mortality
Adolescent
Antineoplastic Agents / adverse effects*
Antiviral Agents / therapeutic use
Child
Child, Preschool
Cohort Studies
Female
Hematopoietic Stem Cell Transplantation*
Humans
Immunocompromised Host*
Immunosuppressive Agents / adverse effects*
Infant
Influenza, Human / drug therapy
Influenza, Human / immunology
Influenza, Human / mortality
Logistic Models
Male
Organ Transplantation*
Paramyxoviridae Infections / drug therapy
Paramyxoviridae Infections / immunology
Paramyxoviridae Infections / mortality
Postoperative Complications / drug therapy
Postoperative Complications / immunology
Postoperative Complications / mortality
Respiratory Syncytial Virus Infections / drug therapy
Respiratory Syncytial Virus Infections / immunology
Respiratory Syncytial Virus Infections / mortality
Respiratory Tract Infections / drug therapy
Respiratory Tract Infections / immunology*
Respiratory Tract Infections / mortality
Respiratory Tract Infections / virology
Retrospective Studies
Risk Factors
Treatment Outcome
Young Adult

Substances

Antineoplastic Agents
Antiviral Agents
Immunosuppressive Agents