Community acquired respiratory virus infections in adult patients undergoing umbilical cord blood transplantation

Bone Marrow Transplant. 2020 Dec;55(12):2261-2269. doi: 10.1038/s41409-020-0943-0. Epub 2020 May 15.

Abstract

Characteristics and risk factors (RFs) of community-acquired respiratory virus (CARV) infections after umbilical cord blood transplantation (UCBT) are lacking. We retrospectively analyzed CARV infections in 216 single-unit myeloablative UCBT recipients. One-hundred and fourteen episodes of CARV infections were diagnosed in 62 (29%) patients. Upper respiratory tract disease (URTD) occurred in 61 (54%) whereas lower respiratory tract disease (LRTD) in 53 (46%). The 5-year cumulative incidence of CARV infection was 29%. RFs for developing CARV infections were: prednisone-based graft-versus-host disease (GVHD) prophylaxis and grade II-IV acute GVHD. RFs analysis of CARV progression to LRTD identified 2007-2009 period and absolute lymphocyte count (ALC) < 0.5 × 109/L. ALC < 0.5 × 109/L had a negative impact on day 60 mortality in both overall CARV and those with LRTD, whereas proven LRTD was associated with higher day 60 mortality. CARV infections had a negative effect on non-relapse mortality. Overall survival at day 60 after CARV detection was significantly lower in recipients with LRTD compared with URTD (74% vs. 93%, respectively). In conclusion, CARV infections after UCBT are frequent and may have a negative effect in the outcomes, in particular in the context of lymphocytopenia.

MeSH terms

  • Adult
  • Cord Blood Stem Cell Transplantation* / adverse effects
  • Graft vs Host Disease* / etiology
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Respiratory Tract Infections* / etiology
  • Retrospective Studies
  • Virus Diseases*