Outcomes of Influenza Infections in Hematopoietic Cell Transplant Recipients: Application of an Immunodeficiency Scoring Index

• Published in: Biology of blood and marrow transplantation 2016-03, Vol.22 (3), p.542-548
• Main Authors: Kmeid, Joumana, Vanichanan, Jakapat, Shah, Dimpy P, El Chaer, Firas, Azzi, Jacques, Ariza-Heredia, Ella J, Hosing, Chitra, Mulanovich, Victor, Chemaly, Roy F
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Allografts; Antiviral therapy; Cancer; Female; Hematology, Oncology and Palliative Medicine; Hematopoietic Stem Cell Transplantation; Humans; Immunocompromised; Immunologic Deficiency Syndromes - blood; Immunologic Deficiency Syndromes - etiology; Immunologic Deficiency Syndromes - mortality; Incidence; Influenza; Influenza A Virus, H3N2 Subtype; Influenza, Human - blood; Influenza, Human - mortality; Influenza, Human - therapy; Male; Middle Aged; Retrospective Studies; Scoring index
• ISSN: 1083-8791; 1523-6536
• DOI: 10.1016/j.bbmt.2015.11.015

Abstract Hematopoietic cell transplant (HCT) recipients have lower immune response to influenza vaccination and are susceptible to lower respiratory tract infection (LRI) and death. We determined clinical characteristics and outcomes of laboratory-confirmed influenza, including 2014/H3N2 infection, in 146 HCT recipients. An immunodeficiency scoring index (ISI) was applied to identify patients at high risk for LRI and death. Thirty-three patients (23%) developed LRI and 7 (5%) died within 30 days of diagnosis. Most patients received antiviral therapy (83%); however, only 18% received it within 48 hours of symptom onset. The incidence of LRI was significantly higher in the ISI high-risk group than it was in the low-risk group ( P