Clinical characterization of human metapneumovirus infection among patients with cancer.
BACKGROUND
Human metapneumovirus is a recently discovered RNA virus that typically causes respiratory disease in children. It has been linked to severe lower airway disease in hematopoietic stem cell and solid-organ transplant recipients. hMPV infection in a large population of patients with underlying cancer and varying degrees of immunosuppression has not been reported. We sought to characterize hMPV infection in patients with cancer.


METHODS
Review of all cases of hMPV infection from two seasons (2005-6 and 2006-7) detected by DFA and/or real-time PCR at MSKCC, a tertiary cancer center in New York City.


RESULTS
Among MSKCC patients with cancer, 51 (2.7%) of 1899 patients were positive for hMPV, including 3.2% with hematologic neoplasm and 1.7% with solid tumors. More children (4.5%) were positive than adults (2.2%). PCR detected twice as many cases as DFA. Cough and fever were common complaints. The longest shedding period was 80 days. 40 patients received radiographic evaluation; of these, 22 showed abnormalities including patchy (11), ground glass (5), and interstitial infiltrates (4).


CONCLUSIONS
hMPV causes a nonspecific respiratory illness and was found in more than 2% of all tested persons with cancer. PCR detected substantially more cases than DFA. Unlike previous reports, we observed no fatalities due to hMPV, including 22 HSCT recipients with the infection.
Kamboj
Mini
M
Infectious Disease Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 9, New York, NY 10065, USA. kambojm@mskcc.org
Gerbin
Marina
M
Huang
Chiung-Kang
CK
Brennan
Carrie
C
Stiles
Jeffrey
J
Balashov
Sergey
S
Park
Steven
S
Kiehn
Timothy E
TE
Perlin
David S
DS
Pamer
Eric G
EG
Sepkowitz
Kent A
KA
D000293:Adolescent; D000328:Adult; D000956:Antigens, Viral / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007223:Infant; D008297:Male; D029121:Metapneumovirus / Q000302:isolation & purification*; D009369:Neoplasms / Q000150:complications*; D009519:New York City; D018184:Paramyxoviridae Infections / Q000453:epidemiology* / Q000503:physiopathology* / Q000821:virology; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000503:physiopathology* / Q000821:virology; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction
D000956:Antigens, Viral; D012367:RNA, Viral