title: Pandemic 2009 Influenza A (H1N1) virus infection in cancer and hematopoietic stem cell transplant recipients; a multicenter observational study.
abstract: BACKGROUND
  During March 2009 a novel Influenza A virus emerged in Mexico. We describe the clinical picture of the pandemic Influenza A (H1N1) Influenza in cancer patients during the 2009 influenza season.
  
  
  METHODS
  Twelve centers participated in a multicenter retrospective observational study of cancer patients with confirmed infection with the 2009 H1N1 Influenza A virus (influenza-like illness or pneumonia plus positive PCR for the 2009 H1N1 Influenza A virus  in respiratory secretions). Clinical data were obtained by retrospective chart review and analyzed.
  
  
  RESULTS
  From May to August 2009, data of 65 patients were collected. Median age was 51 years, 57 % of the patients were female. Most patients (47) had onco-hematological cancers and 18 had solid tumors. Cancer treatment mainly consisted of chemotherapy (46), or stem cell transplantation (SCT) (16). Only 19 of 64 patients had received the 2009 seasonal Influenza vaccine. Clinical presentation included pneumonia (43) and upper respiratory tract infection (22). Forty five of 58 ambulatory patients were admitted. Mechanical ventilation was required in 12 patients (18%). Treatment included oseltamivir monotherapy or in combination with amantadine for a median of 7 days. The global 30-day mortality rate was 18%. All 12 deaths were among the non-vaccinated patients. No deaths were observed among the 19 vaccinated patients. Oxygen saturation <96% at presentation was a predictor of mortality (OR 19.5; 95%CI: 2.28 to 165.9).
  
  
  CONCLUSIONS
  In our cancer patient population, the pandemic 2009 Influenza A (H1N1) virus was associated with high incidence of pneumonia (66%), and 30-day mortality (18.5%). Saturation <96% was significantly associated with death. No deaths were observed among vaccinated patients.
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina.
authors.forename: Maria Cecilia
authors.initials: MC
authors.lastname: Dignani
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Infectious Diseases, Instituto de Oncología Angel H. Roffo, University of Buenos Aires, Buenos Aires, 1417, Argentina.
authors.forename: Patricia
authors.initials: P
authors.lastname: Costantini
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Infectious Diseases, Sanatorio Anchorena 1425 and Sanatorio Trinidad Mitre, Buenos Aires, 1430, Argentina.
authors.forename: Claudia
authors.initials: C
authors.lastname: Salgueira
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Infectious Diseases, Hospital Británico, Buenos Aires, 1280, Argentina.
authors.forename: Rosana
authors.initials: R
authors.lastname: Jordán
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Infectious Diseases, Hospital Rossi, Buenos Aires, 1900, Argentina.
authors.forename: Graciela
authors.initials: G
authors.lastname: Guerrini
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Infectious Diseases, Hospital Italiano, Buenos Aires, 1181, Argentina.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Valledor
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Infectious Diseases, CEMIC, Buenos Aires, 1425, Argentina.
authors.forename: Fabián
authors.initials: F
authors.lastname: Herrera
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Infectious Diseases, Hospital Municipal de Oncología "Marie Curie", Buenos Aires, 1405, Argentina.
authors.forename: Andrea
authors.initials: A
authors.lastname: Nenna
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Infectious Diseases, FLENI, Buenos Aires, 1428, Argentina.
authors.forename: Claudia
authors.initials: C
authors.lastname: Mora
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Hospital San Martín, Buenos Aires, 1900, Argentina.
authors.forename: Inés
authors.initials: I
authors.lastname: Roccia-Rossi
authors.affiliation: Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Infectious Diseases, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, 1120, Argentina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Stecher
authors.affiliation: Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Infectious Diseases, Hospital Aeronáutico Central, Buenos Aires, 1437, Argentina.
authors.forename: Edith
authors.initials: E
authors.lastname: Carbone
authors.affiliation: Infectious Diseases, FUNDALEU, Buenos Aires, 1114, Argentina.
authors.forename: Ana
authors.initials: A
authors.lastname: Laborde
authors.affiliation: Infectious Diseases, Hospital Británico, Buenos Aires, 1280, Argentina ; Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Efron
authors.affiliation: Infectious Diseases, Sanatorio Anchorena 1425 and Sanatorio Trinidad Mitre, Buenos Aires, 1430, Argentina ; Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina.
authors.forename: Javier
authors.initials: J
authors.lastname: Altclas
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Infectious Diseases, Hospital Rossi, Buenos Aires, 1900, Argentina.
authors.forename: Aníbal
authors.initials: A
authors.lastname: Calmaggi
authors.affiliation: Commission of Infections in Immunocompromised Patients, Argentinean Society of Infectious Diseases (SADI), Buenos Aires, 1085, Argentina ; Bone Marrow Transplant, CETRAMOR, Rosario, Pcia. Sta Fé, 2000, Argentina.
authors.forename: José
authors.initials: J
authors.lastname: Cozzi