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Novel factors to predict respiratory viral disease progression in allogeneic hematopoietic cell transplant recipients

We assessed novel factors and the immunodeficiency scoring index (ISI) to predict progression to lower respiratory tract infection (LRTI) among hematopoietic cell transplant (HCT) recipients presenting with upper respiratory tract infection (URTI) with 12 viruses in the PCR era. We retrospectively a...

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Autores principales: Ogimi, Chikara, Xie, Hu, Waghmare, Alpana, Jerome, Keith R., Leisenring, Wendy M., Ueda Oshima, Masumi, Carpenter, Paul A., Englund, Janet A., Boeckh, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853301/
https://www.ncbi.nlm.nih.gov/pubmed/35173288
http://dx.doi.org/10.1038/s41409-022-01575-z
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author Ogimi, Chikara
Xie, Hu
Waghmare, Alpana
Jerome, Keith R.
Leisenring, Wendy M.
Ueda Oshima, Masumi
Carpenter, Paul A.
Englund, Janet A.
Boeckh, Michael
author_facet Ogimi, Chikara
Xie, Hu
Waghmare, Alpana
Jerome, Keith R.
Leisenring, Wendy M.
Ueda Oshima, Masumi
Carpenter, Paul A.
Englund, Janet A.
Boeckh, Michael
author_sort Ogimi, Chikara
collection PubMed
description We assessed novel factors and the immunodeficiency scoring index (ISI) to predict progression to lower respiratory tract infection (LRTI) among hematopoietic cell transplant (HCT) recipients presenting with upper respiratory tract infection (URTI) with 12 viruses in the PCR era. We retrospectively analyzed the first respiratory virus detected by multiplex PCR in allogeneic HCT recipients (4/2008–9/2018). We used Cox proportional hazards models to examine factors for progression to LRTI within 90 days among patients presenting with URTI. A total of 1027 patients (216 children and 811 adults) presented with URTI only. Among these, 189 (18%) progressed to LRTI (median: 12 days). Multivariable models demonstrated a history of  >1 transplant, age  ≥40 years, time post-HCT (≤30 days), systemic steroids, hypoalbuminemia, hyperglycemia, cytopenia, and high ISI (scores 7–12) were associated with an increased risk of progression to LRTI. Respiratory syncytial virus and human metapneumovirus showed the highest progression risk. Patients with ≥3 independent risk factors or high ISI scores were highly likely to progress to LRTI. We identified novel risk factors for progression to LRTI, including history of multiple transplants and hyperglycemia, suggesting an intervention opportunity with glycemic control. ISI and number of risk factors appear to predict disease progression across several viruses.
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spelling pubmed-88533012022-02-18 Novel factors to predict respiratory viral disease progression in allogeneic hematopoietic cell transplant recipients Ogimi, Chikara Xie, Hu Waghmare, Alpana Jerome, Keith R. Leisenring, Wendy M. Ueda Oshima, Masumi Carpenter, Paul A. Englund, Janet A. Boeckh, Michael Bone Marrow Transplant Article We assessed novel factors and the immunodeficiency scoring index (ISI) to predict progression to lower respiratory tract infection (LRTI) among hematopoietic cell transplant (HCT) recipients presenting with upper respiratory tract infection (URTI) with 12 viruses in the PCR era. We retrospectively analyzed the first respiratory virus detected by multiplex PCR in allogeneic HCT recipients (4/2008–9/2018). We used Cox proportional hazards models to examine factors for progression to LRTI within 90 days among patients presenting with URTI. A total of 1027 patients (216 children and 811 adults) presented with URTI only. Among these, 189 (18%) progressed to LRTI (median: 12 days). Multivariable models demonstrated a history of  >1 transplant, age  ≥40 years, time post-HCT (≤30 days), systemic steroids, hypoalbuminemia, hyperglycemia, cytopenia, and high ISI (scores 7–12) were associated with an increased risk of progression to LRTI. Respiratory syncytial virus and human metapneumovirus showed the highest progression risk. Patients with ≥3 independent risk factors or high ISI scores were highly likely to progress to LRTI. We identified novel risk factors for progression to LRTI, including history of multiple transplants and hyperglycemia, suggesting an intervention opportunity with glycemic control. ISI and number of risk factors appear to predict disease progression across several viruses. Nature Publishing Group UK 2022-02-16 2022 /pmc/articles/PMC8853301/ /pubmed/35173288 http://dx.doi.org/10.1038/s41409-022-01575-z Text en © The Author(s), under exclusive licence to Springer Nature Limited 2022 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Article
Ogimi, Chikara
Xie, Hu
Waghmare, Alpana
Jerome, Keith R.
Leisenring, Wendy M.
Ueda Oshima, Masumi
Carpenter, Paul A.
Englund, Janet A.
Boeckh, Michael
Novel factors to predict respiratory viral disease progression in allogeneic hematopoietic cell transplant recipients
title Novel factors to predict respiratory viral disease progression in allogeneic hematopoietic cell transplant recipients
title_full Novel factors to predict respiratory viral disease progression in allogeneic hematopoietic cell transplant recipients
title_fullStr Novel factors to predict respiratory viral disease progression in allogeneic hematopoietic cell transplant recipients
title_full_unstemmed Novel factors to predict respiratory viral disease progression in allogeneic hematopoietic cell transplant recipients
title_short Novel factors to predict respiratory viral disease progression in allogeneic hematopoietic cell transplant recipients
title_sort novel factors to predict respiratory viral disease progression in allogeneic hematopoietic cell transplant recipients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853301/
https://www.ncbi.nlm.nih.gov/pubmed/35173288
http://dx.doi.org/10.1038/s41409-022-01575-z
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