title: Adenoviral infections in adult allogeneic hematopoietic SCT recipients: a single center experience.
abstract: Disseminated adenoviral infection (AI) is associated with profound immunosuppression and poor outcome after allogeneic hematopoietic SCT (allo-HSCT). A better understanding of AI in allo-HSCT recipients can serve as a basis to develop more effective management strategies. We evaluated all adult patients who received allo-HSCT at MD Anderson Cancer Center between 1999 and 2008. Among the 2879 allo-HSCT patients, 73 (2.5%) were diagnosed with AI. Enteritis (26%) and pneumonia (24%) were the most common clinical manifestations; pneumonia was the most common cause of adenovirus-associated death. A multivariable Bayesian logistic regression showed that when the joint effects of all covariates were accounted for, cord blood transplant, absolute lymphocyte count (ALC) ≤ 200/mm(3) and male gender were associated with a higher probability of disseminated AI. The OS was significantly worse for patients with AI that was disseminated rather than localized (median of 5 months vs median of 28 months, P<0.001) and for patients with ALC ≤ 200/mm(3) (P<0.001). Disseminated AI, in patients who received allo-HSCT, is a significant cause of morbidity and mortality. Strategies for early diagnosis and intervention are essential, especially for high-risk patients.
authors.affiliation: Department of Leukemia, The University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: M
authors.initials: M
authors.lastname: Yilmaz
authors.forename: R F
authors.initials: RF
authors.lastname: Chemaly
authors.forename: X Y
authors.initials: XY
authors.lastname: Han
authors.forename: P F
authors.initials: PF
authors.lastname: Thall
authors.forename: P S
authors.initials: PS
authors.lastname: Fox
authors.forename: J J
authors.initials: JJ
authors.lastname: Tarrand
authors.forename: M J
authors.initials: MJ
authors.lastname: De Lima
authors.forename: C M
authors.initials: CM
authors.lastname: Hosing
authors.forename: U R
authors.initials: UR
authors.lastname: Popat
authors.forename: E
authors.initials: E
authors.lastname: Shpall
authors.forename: R E
authors.initials: RE
authors.lastname: Champlin
authors.forename: M H
authors.initials: MH
authors.lastname: Qazilbash
mesh_terms: D000256:Adenoviridae / Q000302:isolation & purification*; D000257:Adenoviridae Infections / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006680:HLA Antigens