Clinical manifestations, prognostic factors, and outcomes of adenovirus pneumonia after allogeneic hematopoietic stem cell transplantation
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Published:2024-05-14
Issue:1
Volume:21
Page:
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ISSN:1743-422X
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Container-title:Virology Journal
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language:en
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Short-container-title:Virol J
Author:
Wang Yuewen,Zhang Xiaohui,Xu Lanping,Wang Yu,Yan Chenhua,Chen Huan,Chen Yuhong,Wei Fangfang,Han Wei,Wang Fengrong,Wang Jingzhi,Huang Xiaojun,Mo Xiaodong
Abstract
Abstract
Background
Severe pneumonia is one of the most important causes of mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Adenovirus (ADV) is a significant cause of severe viral pneumonia after allo-HSCT, and we aimed to identify the clinical manifestations, prognostic factors, and outcomes of ADV pneumonia after allo-HSCT.
Methods
Twenty-nine patients who underwent allo-HSCT at the Peking University Institute of Hematology and who experienced ADV pneumonia after allo-HSCT were enrolled in this study. The Kaplan–Meier method was used to estimate the probability of overall survival (OS). Potential prognostic factors for 100-day OS after ADV pneumonia were evaluated through univariate and multivariate Cox regression analyses.
Results
The incidence rate of ADV pneumonia after allo-HSCT was approximately 0.71%. The median time from allo-HSCT to the occurrence of ADV pneumonia was 99 days (range 17–609 days). The most common clinical manifestations were fever (86.2%), cough (34.5%) and dyspnea (31.0%). The 100-day probabilities of ADV-related mortality and OS were 40.4% (95% CI 21.1%-59.7%) and 40.5% (95% CI 25.2%-64.9%), respectively. Patients with low-level ADV DNAemia had lower ADV-related mortality and better OS than did those with high-level (≥ 106 copies/ml in plasma) ADV DNAemia. According to the multivariate analysis, high-level ADV DNAemia was the only risk factor for intensive care unit admission, invasive mechanical ventilation, ADV-related mortality, and OS after ADV pneumonia.
Conclusions
We first reported the prognostic factors and confirmed the poor outcomes of patients with ADV pneumonia after allo-HSCT. Patients with high-level ADV DNAemia should receive immediate and intensive therapy.
Funder
National Key Research and Development Program of China National Natural Science Foundation of China CAMS Innovation Fund for Medical Sciences Peking University People’s Hospital Research and Development Funds Natural Science Foundation of Beijing Tongzhou District Distinguished Young Scholars
Publisher
Springer Science and Business Media LLC
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