Risk factors for lower respiratory tract disease and outcomes in allogeneic hematopoietic stem cell transplantation recipients with influenza virus infection |
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| Affiliation: | 1. Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan;2. Department of Hematology, Ozawa Hospital, Odawara, Japan;3. Department of Hematology, Ebina General Hospital, Ebina, Japan;4. Department of Hematology, Isehara Kyodo Hospital, Isehara, Japan;1. Department of Laboratory Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China;2. Department of Respiratory Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China;1. Department of Pediatrics, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 7010192, Japan;2. Department of Medical Welfare for Children, Faculty of Health and Welfare, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki City, Okayama, 7010193, Japan;1. Department of Infectious Diseases, Kagawa Prefectural Central Hospital 1-2-1 Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan;2. Departments of General and Gastroenterological Surgery, Kagawa Prefectural Central Hospital 1-2-1 Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan;2. Department of Head and Neck Surgery, Miyagi Cancer Center, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, Japan;3. Department of Head and Neck Oncology Division, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan;1. Department of Infectious Diseases, St. Luke''s International Hospital: 9-1, Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan;2. Graduate School of Public Health, St. Luke''s International University: OMURA Susumu & Mieko Memorial St. Luke''s Center for Clinical Academia, 5th Floor, 3-6-2, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan;1. Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia;2. Pediatric Intensive Care Unit, Department of Pediatrics, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia;3. Department of Pharmacy Services, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia |
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| Abstract: | IntroductionInfluenza virus infection (IVI) is frequent in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients, and reports from several countries indicate high morbidity and mortality from progression to lower respiratory tract disease (LRTD). However, there have been no reports on IVI clinical characteristics, treatment outcomes, and risk factor for progression to LRTD among allo-HSCT recipients in Japan.MethodsWe retrospectively reviewed the medical charts of allo-HSCT recipients who developed IVI between 2012 and 2019.ResultsForty-eight cases of IVI following allo-HSCT were identified at our institution. The median age was 42 years, and median time from allo-HSCT to IVI was 25 months. Thirty-seven patients (77.1%) were administered neuraminidase inhibitors (NAIs) as antiviral therapy within 48 h of symptom onset (early therapy), whereas 11 (22.9%) received NAI over 48 h after onset (delayed therapy). Subsequently, 12 patients (25.0%) developed LRTD after IVI. Multivariate analysis identified older age (hazard ratio [HR], 7.65; 95% confidence interval [CI], 2.22–26.3) and bronchiolitis obliterans (HR, 5.74; 95% CI, 1.57–21.0) as independent risk factors for progression to LRTD. Moreover, land-mark analysis showed that early therapy prevented progression to LRTD (11.8% vs. 45.5%, P = 0.013). The IVI-related mortality rate was 2.1%.ConclusionsEarly NAI treatment is recommended for reducing the risk of LRTD progression due to IVI in allo-HSTC recipients, particularly for older patients and those with bronchiolitis obliterans. |
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| Keywords: | Influenza virus Secondary pneumonia Hematopoietic stem cell transplantation |
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