title: Outcome of pandemic H1N1 infections in hematopoietic stem cell transplant recipients.
abstract: During 2009, a new strain of A/H1N1 influenza appeared and became pandemic. A prospective study was performed to collect data regarding risk factors and outcome of A/H1N1 in hematopoietic stem cell transplant recipients. Only verified pandemic A/H1N1 influenza strains were included: 286 patients were reported, 222 allogeneic and 64 autologous recipients. The median age was 38.3 years and the median time from transplant was 19.4 months. Oseltamivir was administered to 267 patients and 15 patients received zanamivir. One hundred and twenty-five patients (43.7%) were hospitalized. Ninety-three patients (32.5%) developed lower respiratory tract disease. In multivariate analysis, risk factors were age (OR 1.025; 1.01-1.04; P=0.002) and lymphopenia (OR 2.49; 1.33-4.67; P<0.001). Thirty-three patients (11.5%) required mechanical ventilation. Eighteen patients (6.3%) died from A/H1N1 infection or its complications. Neutropenia (P=0.03) and patient age (P=0.04) were significant risk factors for death. The 2009 A/H1N1 influenza pandemic caused severe complications in stem cell transplant recipients.
authors.affiliation: Dept. of Haematology, Karolinska University Hospital, Stockholm, Sweden. Per.Ljungman@ki.se
authors.forename: Per
authors.initials: P
authors.lastname: Ljungman
authors.forename: Rafael
authors.initials: R
authors.lastname: de la Camara
authors.forename: Lena
authors.initials: L
authors.lastname: Perez-Bercoff
authors.forename: Manuel
authors.initials: M
authors.lastname: Abecasis
authors.forename: Jose Bartolo
authors.initials: JB
authors.lastname: Nieto Campuzano
authors.forename: M Jimena
authors.initials: MJ
authors.lastname: Cannata-Ortiz
authors.forename: Catherine
authors.initials: C
authors.lastname: Cordonnier
authors.forename: Hermann
authors.initials: H
authors.lastname: Einsele
authors.forename: Marta
authors.initials: M
authors.lastname: Gonzalez-Vicent
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Espigado
authors.forename: Jörg
authors.initials: J
authors.lastname: Halter
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Martino
authors.forename: Bilal
authors.initials: B
authors.lastname: Mohty
authors.forename: Gülsan
authors.initials: G
authors.lastname: Sucak
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Ullmann
authors.forename: Lourdes
authors.initials: L
authors.lastname: Vázquez
authors.forename: Katherine N
authors.initials: KN
authors.lastname: Ward
authors.forename: Dan
authors.initials: D
authors.lastname: Engelhard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D008231:Lymphopenia / Q000150:complications; D008875:Middle Aged; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D011014:Pneumonia / Q000150:complications; D012307:Risk Factors; D016896:Treatment Outcome; D014611:Vaccination; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir