Airflow Decline after Myeloablative Allogeneic Hematopoietic Cell Transplantation: The Role of Community Respiratory Viruses

• Published in: The Journal of Infectious Diseases 2006-06, Vol.193 (12), p.1619-1625
• Main Authors: Erard, Veronique, Chien, Jason W., Kim, Hyung W., Nichols, W. Garrett, Flowers, Mary E., Martin, Paul J., Corey, Lawrence, Boeckh, Michael
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Blood; Bone marrow; Community-Acquired Infections - physiopathology; Community-Acquired Infections - virology; Cytomegalovirus Infections - physiopathology; Female; Fundamental and applied biological sciences. Psychology; Graft vs host disease; Hematocrit; Hematopoietic Stem Cell Transplantation; Humans; Infections; Infectious diseases; Major and Brief Reports; Male; Medical sciences; Microbiology; Middle Aged; Parainfluenza virus; Paramyxoviridae infections; Paramyxoviridae Infections - physiopathology; Pneumonia, Viral - physiopathology; Pulmonary function tests; Pulmonary Ventilation; Respiratory syncytial virus; Respiratory syncytial virus infections; Respiratory Syncytial Virus Infections - physiopathology; Respiratory Tract Infections - physiopathology; Respiratory Tract Infections - virology; Retrospective Studies; Risk Factors; Transplantation, Homologous; Viral infections; Viruses
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/504268

We conducted a 12-year retrospective study to determine the effects that the community respiratory-virus species and the localization of respiratory-tract virus infection have on severe airflow decline, a serious and fatal complication occurring after hematopoietic cell transplantation (HCT). Of 132 HCT recipients with respiratory-tract virus infection during the initial 100 days after HCT, 50 (38%) developed airflow decline ⩽1 year after HCT. Lower-respiratory-tract infection with parainfluenza (odds ratio [OR], 17.9 [95% confidence interval {CI}, 2.0–160]; P=.01) and respiratory syncytial virus (OR, 3.6 [95% CI, 1.0–13]; P=.05) independently increased the risk of development of airflow decline ⩽1 year after HCT. The airflow decline was immediately detectable after infection and was strongest for lower-respiratory-tract infection with parainfluenza virus; it stabilized during the months after the respiratory-tract virus infection, but, at ⩽1 year after HCT, the initial lung function was not restored. Thus, community respiratory virus–associated airflow decline seems to be specific to viral species and infection localization