title: The clinical features and outcome of 2009 H1N1 influenza infection in allo-SCT patients: a British Society of Blood and Marrow Transplantation study.
abstract: The clinical course of 2009 H1N1 influenza in Allo-SCT patients is unknown. Data were collected in the UK from October 2009 to April 2010 on laboratory-confirmed cases of H1N1 influenza in Allo-SCT recipients. H1N1 infection was diagnosed in 60 patients, median age 42 years, at a median of 10 months post-SCT. Twenty-one patients (35%) developed pneumonia and nine (15%) required admission to intensive care units. Actuarial mortality was 7% at 28 days and 19% 4 months post-diagnosis of 2009 H1N1 influenza. Increasing age and pre-existing lung disease were risk factors for pneumonia (P=0.006 and 0.037, respectively); older age was a risk factor for death (P=0.012). Morbidity and mortality from 2009 H1N1 influenza in SCT patients exceeds that of immunocompetent patients, but parallels that in other critically ill hospitalised cohorts; the elderly and those with chronic pulmonary disease are at greatest risk.
authors.affiliation: Bristol Adult Bone Marrow Transplant Unit, University Hospitals Bristol, Bristol, UK.
authors.forename: R E
authors.initials: RE
authors.lastname: Protheroe
authors.forename: K E
authors.initials: KE
authors.lastname: Kirkland
authors.forename: R M
authors.initials: RM
authors.lastname: Pearce
authors.forename: K
authors.initials: K
authors.lastname: Kaminaris
authors.forename: A
authors.initials: A
authors.lastname: Bloor
authors.forename: M N
authors.initials: MN
authors.lastname: Potter
authors.forename: S
authors.initials: S
authors.lastname: Nagra
authors.forename: M H
authors.initials: MH
authors.lastname: Gilleece
authors.forename: I G
authors.initials: IG
authors.lastname: McQuaker
authors.forename: G
authors.initials: G
authors.lastname: Jackson
authors.forename: G
authors.initials: G
authors.lastname: Cook
authors.forename: D I
authors.initials: DI
authors.lastname: Marks
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003422:Critical Care; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D058873:Pandemics; D011014:Pneumonia / Q000401:mortality* / Q000628:therapy; D012955:Societies, Medical; D033581:Stem Cell Transplantation; D015996:Survival Rate; D013997:Time Factors; D014184:Transplantation, Homologous; D006113:United Kingdom / Q000453:epidemiology