tetano
Editor, Senior Moderator
Int J Infect Dis
. 2023 Mar 29;S1201-9712(23)00124-8.
doi: 10.1016/j.ijid.2023.03.045. Online ahead of print.
Prognostic factors for the development of lower respiratory tract infection after influenza virus infection in allogeneic hematopoietic stem cell transplantation recipients: A KSGCT Multicenter Analysis
Kaito Harada[SUP] 1 [/SUP], Makoto Onizuka[SUP] 2 [/SUP], Takehiko Mori[SUP] 3 [/SUP], Hiroaki Shimizu[SUP] 4 [/SUP], Sachiko Seo[SUP] 5 [/SUP], Nobuyuki Aotsuka[SUP] 6 [/SUP], Yusuke Takeda[SUP] 7 [/SUP], Noritaka Sekiya[SUP] 8 [/SUP], Machiko Kusuda[SUP] 9 [/SUP], Shinichiro Fujihara[SUP] 10 [/SUP], Sawako Shiraiwa[SUP] 2 [/SUP], Katsuhiro Shono[SUP] 11 [/SUP], Naoki Shingai[SUP] 4 [/SUP], Heiwa Kanamori[SUP] 12 [/SUP], Mamiko Momoki[SUP] 13 [/SUP], Satoru Takada[SUP] 14 [/SUP], Junichi Mukae[SUP] 4 [/SUP], Shinichi Masuda[SUP] 6 [/SUP], Kinuko Mitani[SUP] 5 [/SUP], Emiko Sakaida[SUP] 7 [/SUP], Tatsuki Tomikawa[SUP] 15 [/SUP], Satoshi Takahashi[SUP] 16 [/SUP], Kensuke Usuki[SUP] 17 [/SUP], Yoshinobu Kanda[SUP] 9 [/SUP]
Affiliations
Abstract
Introduction: Influenza virus infection (IVI) occasionally causes lower respiratory tract infection (LRTI) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Although progression to LRTI entails high mortality, the role of early antiviral therapy for its prevention has not been fully elucidated.
Methods: This was a multicenter retrospective study using an additional questionnaire. Allo-HSCT recipients who developed IVI between 2012 and 2020 were included.
Results: A total of 278 cases of IVI after allo-HSCT were identified from 15 institutions. The median patient age was 49 years, and the median time from allo-HSCT to IVI was 918 days. Neuraminidase inhibitors were administered within 48 hours of symptom onset (early NAI) in 199 patients (76.9%). Subsequently, 36 patients (12.3%) developed LRTI. On multivariate analysis, age ≥50 years (hazard ratio
, 2.16; 95% confidence interval [CI], 1.02-4.58) and moderate-to-severe chronic graft-versus-host disease (HR, 2.28; 95%CI, 1.14-4.58) were significantly associated with progression to LRTI, whereas early NAI suppressed the progression (HR, 0.17; 95% CI, 0.06-0.46). The IVI-related mortality rate was 2.2%.
Conclusions: To reduce the risk of LRTI development after IVI, early NAI therapy should be considered in allo-HSCT recipients, especially with older patients and those with chronic graft-versus-host disease.
Keywords: hematopoietic stem cell transplantation; influenza virus; secondary pneumonia.
. 2023 Mar 29;S1201-9712(23)00124-8.
doi: 10.1016/j.ijid.2023.03.045. Online ahead of print.
Prognostic factors for the development of lower respiratory tract infection after influenza virus infection in allogeneic hematopoietic stem cell transplantation recipients: A KSGCT Multicenter Analysis
Kaito Harada[SUP] 1 [/SUP], Makoto Onizuka[SUP] 2 [/SUP], Takehiko Mori[SUP] 3 [/SUP], Hiroaki Shimizu[SUP] 4 [/SUP], Sachiko Seo[SUP] 5 [/SUP], Nobuyuki Aotsuka[SUP] 6 [/SUP], Yusuke Takeda[SUP] 7 [/SUP], Noritaka Sekiya[SUP] 8 [/SUP], Machiko Kusuda[SUP] 9 [/SUP], Shinichiro Fujihara[SUP] 10 [/SUP], Sawako Shiraiwa[SUP] 2 [/SUP], Katsuhiro Shono[SUP] 11 [/SUP], Naoki Shingai[SUP] 4 [/SUP], Heiwa Kanamori[SUP] 12 [/SUP], Mamiko Momoki[SUP] 13 [/SUP], Satoru Takada[SUP] 14 [/SUP], Junichi Mukae[SUP] 4 [/SUP], Shinichi Masuda[SUP] 6 [/SUP], Kinuko Mitani[SUP] 5 [/SUP], Emiko Sakaida[SUP] 7 [/SUP], Tatsuki Tomikawa[SUP] 15 [/SUP], Satoshi Takahashi[SUP] 16 [/SUP], Kensuke Usuki[SUP] 17 [/SUP], Yoshinobu Kanda[SUP] 9 [/SUP]
Affiliations
- PMID: 37001798
- DOI: 10.1016/j.ijid.2023.03.045
Abstract
Introduction: Influenza virus infection (IVI) occasionally causes lower respiratory tract infection (LRTI) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Although progression to LRTI entails high mortality, the role of early antiviral therapy for its prevention has not been fully elucidated.
Methods: This was a multicenter retrospective study using an additional questionnaire. Allo-HSCT recipients who developed IVI between 2012 and 2020 were included.
Results: A total of 278 cases of IVI after allo-HSCT were identified from 15 institutions. The median patient age was 49 years, and the median time from allo-HSCT to IVI was 918 days. Neuraminidase inhibitors were administered within 48 hours of symptom onset (early NAI) in 199 patients (76.9%). Subsequently, 36 patients (12.3%) developed LRTI. On multivariate analysis, age ≥50 years (hazard ratio
, 2.16; 95% confidence interval [CI], 1.02-4.58) and moderate-to-severe chronic graft-versus-host disease (HR, 2.28; 95%CI, 1.14-4.58) were significantly associated with progression to LRTI, whereas early NAI suppressed the progression (HR, 0.17; 95% CI, 0.06-0.46). The IVI-related mortality rate was 2.2%.
Conclusions: To reduce the risk of LRTI development after IVI, early NAI therapy should be considered in allo-HSCT recipients, especially with older patients and those with chronic graft-versus-host disease.
Keywords: hematopoietic stem cell transplantation; influenza virus; secondary pneumonia.