TY - JOUR
T1 - Adenovirus infections in adult recipients of blood and marrow transplants
AU - La Rosa, Alberto M.
AU - Champlin, Richard E.
AU - Mirza, Nadeem
AU - Gajewski, James
AU - Giralt, Sergio
AU - Rolston, Kenneth V.
AU - Raad, Isaam
AU - Jacobson, Kalen
AU - Kontoyiannis, Dimitrios
AU - Elting, Linda
AU - Whimbey, Estella
PY - 2001/3/15
Y1 - 2001/3/15
N2 - Adenoviruses are increasingly recognized pathogens that affect blood and marrow transplant (BMT) recipients. Experiences with 2889 adult BMT recipients were reviewed to study the incidence, clinical spectrum, risk factors for dissemination, response to therapy, and outcome of adenovirus infections. Eight-five patients (3%) were diagnosed by means of culture (n = 85) or culture and histopathological examination (n = 6). Nine patients had asymptomatic viruria, and 76 had symptomatic infections, which included upper respiratory tract infection (n = 20), enteritis (n = 18), hemorrhagic cystitis (n = 10), pneumonia (n = 15), and disseminated disease (n = 13). The overall mortality rate was 26%. A higher mortality rate was observed among patients with pneumonia (73%) and disseminated disease (61%). Risk factors for dissemination included receipt of an allogeneic transplant, presence of graft-versus-host disease (GVHD), and receipt of concurrent immunosuppressive therapy. Intravenous ribavirin was not associated with an appreciable benefit among 12 patients who received this treatment. In conclusion, adenovirus infections are an important cause of morbidity and mortality in adult BMT recipients, particularly allogeneic transplant recipients with GVHD who are receiving immunosuppressive therapy. The need for an effective, nontoxic antiviral therapy is apparent.
AB - Adenoviruses are increasingly recognized pathogens that affect blood and marrow transplant (BMT) recipients. Experiences with 2889 adult BMT recipients were reviewed to study the incidence, clinical spectrum, risk factors for dissemination, response to therapy, and outcome of adenovirus infections. Eight-five patients (3%) were diagnosed by means of culture (n = 85) or culture and histopathological examination (n = 6). Nine patients had asymptomatic viruria, and 76 had symptomatic infections, which included upper respiratory tract infection (n = 20), enteritis (n = 18), hemorrhagic cystitis (n = 10), pneumonia (n = 15), and disseminated disease (n = 13). The overall mortality rate was 26%. A higher mortality rate was observed among patients with pneumonia (73%) and disseminated disease (61%). Risk factors for dissemination included receipt of an allogeneic transplant, presence of graft-versus-host disease (GVHD), and receipt of concurrent immunosuppressive therapy. Intravenous ribavirin was not associated with an appreciable benefit among 12 patients who received this treatment. In conclusion, adenovirus infections are an important cause of morbidity and mortality in adult BMT recipients, particularly allogeneic transplant recipients with GVHD who are receiving immunosuppressive therapy. The need for an effective, nontoxic antiviral therapy is apparent.
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U2 - 10.1086/319352
DO - 10.1086/319352
M3 - Article
C2 - 11247710
AN - SCOPUS:0035867374
SN - 1058-4838
VL - 32
SP - 871
EP - 876
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 6
ER -