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

Bone Marrow Transplantation volume 55, pages 2261–2269 (2020)Cite this article

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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.

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Fig. 1: CARV infections.
Fig. 2: Cumulative incidence of CARV.
Fig. 3: Survival outcomes.

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Authors and Affiliations

  1. Department of Hematology, University Hospital La Fe, Valencia, Spain

    Juan Montoro, Jaime Sanz, Ignacio Lorenzo, Aitana Balaguer-Roselló, Manuel Guerreiro, Guillermo F. Sanz, Miguel A. Sanz & José Luis Piñana

  2. CIBERONC, Instituto Carlos III, Madrid, Spain

    Jaime Sanz, Guillermo F. Sanz, Miguel A. Sanz & José Luis Piñana

  3. Department of Infectious Diseases, University Hospital La Fe, Valencia, Spain

    Miguel Salavert

  4. Department of Microbiology, University Hospital La Fe, Valencia, Spain

    María Dolores Gómez & Eva M. González Barberá

  5. Department of Laboratory Medicine, University Hospital La Fe, Valencia, Spain

    Cristina Aguado & Luiza Tofán

  6. Department of Medicine, University of Valencia, Valencia, Spain

    Miguel A. Sanz

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  2. Jaime Sanz
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Contributions

JM, JS, and JLP conceived the study and interpreted the data; JM, and JLP wrote the paper; JM, JS, and JLP, performed the statistical analyses; IL, AB-R, MS, MDG, MG, EMGB, GFS, MAS, reviewed the paper and contributed to the final draft.

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Correspondence to José Luis Piñana.

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Montoro, J., Sanz, J., Lorenzo, I. et al. Community acquired respiratory virus infections in adult patients undergoing umbilical cord blood transplantation. Bone Marrow Transplant 55, 2261–2269 (2020). https://doi.org/10.1038/s41409-020-0943-0

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