Airflow decline after myeloablative allogeneic hematopoietic cell transplantation: the role of community respiratory viruses.
We conducted a 12-year retrospective study to determine the effects that the community respiratory-virus species and the localization of respiratory-tract virus infection have on severe airflow decline, a serious and fatal complication occurring after hematopoietic cell transplantation (HCT). Of 132 HCT recipients with respiratory-tract virus infection during the initial 100 days after HCT, 50 (38%) developed airflow decline < or =1 year after HCT. Lower-respiratory-tract infection with parainfluenza (odds ratio [OR], 17.9 [95% confidence interval {CI}, 2.0-160]; P=.01) and respiratory syncytial virus (OR, 3.6 [95% CI, 1.0-13]; P=.05) independently increased the risk of development of airflow decline < or =1 year after HCT. The airflow decline was immediately detectable after infection and was strongest for lower-respiratory-tract infection with parainfluenza virus; it stabilized during the months after the respiratory-tract virus infection, but, at < or =1 year after HCT, the initial lung function was not restored. Thus, community respiratory virus-associated airflow decline seems to be specific to viral species and infection localization.
Erard
Veronique
V
Division of Clinical Research, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA 98109-1024, USA.
Chien
Jason W
JW
Kim
Hyung W
HW
Nichols
W Garrett
WG
Flowers
Mary E
ME
Martin
Paul J
PJ
Corey
Lawrence
L
Boeckh
Michael
M
D000328:Adult; D017714:Community-Acquired Infections / Q000503:physiopathology / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000503:physiopathology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D018184:Paramyxoviridae Infections / Q000503:physiopathology; D011024:Pneumonia, Viral / Q000503:physiopathology; D012123:Pulmonary Ventilation; D018357:Respiratory Syncytial Virus Infections / Q000503:physiopathology; D012141:Respiratory Tract Infections / Q000503:physiopathology / Q000821:virology*; D012189:Retrospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous