The Impact of Pretransplant Respiratory Virus Detection on Posttransplant Outcomes in Children Undergoing Hematopoietic Cell Transplantation

• Published in: Clinical infectious diseases 2024-09, Vol.79 (3), p.761-771
• Main Authors: Kim, Sara Ruth, Nordlander, Anna, Xie, Hu, Kim, Yae-Jean, Ogimi, Chikara, Thakar, Monica S, Leisenring, Wendy, Englund, Janet A, Boeckh, Michael, Waghmare, Alpana
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Child, Preschool; Female; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Infant; Male; Medicin och hälsovetenskap; Respiratory Tract Infections - virology; Retrospective Studies; Risk Factors
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1093/cid/ciae216

Pretransplant respiratory virus (RV) infections have been associated with negative transplant outcomes in adult hematopoietic cell transplantation (HCT) recipients. In the era of HCT delay because of high-risk RVs, we examined the impact of pretransplant RV detection on transplant outcomes in pediatric HCT recipients. This retrospective cohort study included pediatric myeloablative allogeneic HCT recipients from 2010 to 2019. All patients were screened for RV at least once within 90 days before HCT using reverse transcriptase polymerase chain reaction (PCR), regardless of symptoms. Posttransplant outcomes included days alive and out of hospital and progression to lower respiratory tract infection (LRTI). Among 310 patients, 134 had an RV detected in the 90 days before HCT. In univariable analysis, transplant factors including younger age, total body irradiation, umbilical cord blood transplantation, lymphocyte count 30 days (P = .007). In the setting of recommending HCT delay for high-risk RVs, symptomatic upper respiratory tract infection, including human rhinovirus infections, may lead to increased duration of hospitalization and early progression to LRTI when transplantation is performed within 30 days of the last positive PCR test.