title: The characteristics and outcomes of parainfluenza virus infections in 200 patients with leukemia or recipients of hematopoietic stem cell transplantation.
abstract: Community respiratory viruses are significant causes of morbidity and mortality in patients with leukemia and hematopoietic stem cell transplant (HSCT) recipients. Data on characteristics and outcomes of parainfluenza virus (PIV) infections in these patients are limited. We reviewed the records of patients with leukemia and HSCT recipients who developed PIV infections to determine the characteristics and outcomes of such infections. We identified 200 patients with PIV infections, including 80 (40%) patients with leukemia and 120 (60%) recipients of HSCT. At presentation, most patients (70%) had an upper respiratory tract infection and the remaining patients (30%) had pneumonia. Neutropenia, APACHE II score more than 15, and respiratory coinfections were independent predictors of progression to pneumonia on multivariate analysis. Overall mortality rate was 9% at 30 days after diagnosis and 17% among patients who had PIV pneumonia, with no significant difference between patients with leukemia and HSCT recipients (16% vs 17%). On multivariate analysis, independent predictors of death were relapsed or refractory underlying malignancy, APACHE II score more than 15, and high-dose steroid use. Patients with leukemia and HSCT are at risk for serious PIV infections, including PIV pneumonia, with a significant mortality rate. We identified multiple risk factors for progression to pneumonia and death.
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009, USA. rfchemaly@mdanderson.org
authors.forename: Roy F
authors.initials: RF
authors.lastname: Chemaly
authors.forename: Santosh S
authors.initials: SS
authors.lastname: Hanmod
authors.forename: Dhanesh B
authors.initials: DB
authors.lastname: Rathod
authors.forename: Shashank S
authors.initials: SS
authors.lastname: Ghantoji
authors.forename: Ying
authors.initials: Y
authors.lastname: Jiang
authors.forename: Arpan
authors.initials: A
authors.lastname: Doshi
authors.forename: Karen
authors.initials: K
authors.lastname: Vigil
authors.forename: Javier A
authors.initials: JA
authors.lastname: Adachi
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Khoury
authors.forename: Jeffery
authors.initials: J
authors.lastname: Tarrand
authors.forename: Chitra
authors.initials: C
authors.lastname: Hosing
authors.forename: Richard
authors.initials: R
authors.lastname: Champlin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D053208:Kaplan-Meier Estimate; D007938:Leukemia / Q000150:complications* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000998:Antiviral Agents