title: Occurrence, risk factors and outcome of adenovirus infection in adult recipients of allogeneic hematopoietic stem cell transplantation.
abstract: Adenovirus (ADV) infections can have a high mortality in immunocompromised patients and are difficult to treat.
  
  
  
  We retrospectively analyzed occurrence and risk factors of ADV infection in 399 adults with hematological disorders undergoing hematopoietic stem cell transplantation (allo-HSCT), focusing on alternative donor transplantation (ADT) and disseminated disease.
  
  
  
  ADV infection occurred in 42 patients (10.5%). Disease was localized in 18 and disseminated in 6 patients. ADV infection was observed in 15% after ADT, performed in 29% of all recipients, and was less frequent (6%) in T-cell-replete (TCR) haploidentical transplantation using post-transplantation cyclophosphamide (PTCY) than in other ADT protocols. Lower age, the use of alternative donor grafts and acute graft-versus-host disease (GvHD)≥grade II were risk factors for ADV infection. After failure of standard antiviral treatment, three patients with disseminated ADV disease received one dose of ADV-specific T cells, resulting in virological response in 2/3 patients, clearance of ADV viremia in 2/2 patients, and survival of 1/3 patients; both patients with pneumonia died.
  
  
  
  ADV infection was of moderate occurrence in our adult recipients of allo-HSCT despite a high proportion of potential high-risk patients receiving ADT. TCR strategies using PTCY might limit ADV complications in haploidentical transplantation. Despite feasible adoptive therapy strategies, outcome of disseminated disease remains dismal.
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany.
authors.forename: Max
authors.initials: M
authors.lastname: Hubmann
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Fritsch
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany.
authors.forename: Anna-Katharina
authors.initials: AK
authors.lastname: Zoellner
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany.
authors.forename: Dusan
authors.initials: D
authors.lastname: Prevalsek
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Engel
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany.
authors.forename: Veit
authors.initials: V
authors.lastname: Bücklein
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany.
authors.forename: Friederike
authors.initials: F
authors.lastname: Mumm
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schulz
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany.
authors.forename: Hans Joachim
authors.initials: HJ
authors.lastname: Stemmler
authors.affiliation: Ludwig-Maximilians-University, Max-von-Pettenkofer-Institut, Munich, Germany.
authors.forename: Gundula
authors.initials: G
authors.lastname: Jäger
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Ledderose
authors.affiliation: Ludwig-Maximilians-University, Faculty of Medicine, Munich, Germany.
authors.forename: Hans Jochem
authors.initials: HJ
authors.lastname: Kolb
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany; Klinikum Schwabing, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Hausmann
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hiddemann
authors.affiliation: Helmholtz Zentrum München, DZIF Research Group Host control of viral latency and reactivation, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Moosmann
authors.affiliation: Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic Stem Cell Transplantation, Munich, Germany. Electronic address: Johanna.Tischer@med.uni-muenchen.de.
authors.forename: Johanna
authors.initials: J
authors.lastname: Tischer
mesh_terms: D000257:Adenoviridae Infections / Q000453:epidemiology* / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D006402:Hematologic Diseases / Q000150:complications* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014184:Transplantation, Homologous / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents
keywords: Adenovirus; Allogeneic hematopoietic stem cell transplantation; Alternative donor transplantation; Disseminated disease