Respiratory Viruses in Transplant Candidates

Kim Y, Waghmare A, Xie H, et al. Respiratory Viruses in Hematopoietic Cell Transplant Candidates: Impact of Preexisting Lower Tract Disease on Outcomes. Blood Advances. 2022; (doi: 10.1182/bloodadvances.2021004915).

The risk of mortality rises with the occurrence of pretransplant lower respiratory disease (LRD) caused by any respiratory virus among myeloablative allogeneic hematopoietic cell transplantation (HCT) recipients. Investigators explored how symptomatic human rhinovirus (HRV) contracted within <90 days before HCT impacted overall mortality, posttransplant LRD, and days alive and out of hospital (DAOH) by the 100th day after HCT. Respiratory virus infection screening for 704 adult HCT recipients out of 1,643 (58% allogeneic recipients) yielded positive results in 307 (44%). HRV was the most commonly detected pathogen (56%), while 45 (15%) of 307 HCT recipients had LRD with the same virus shortly after HCT. No associations were drawn between pretransplant upper respiratory infection (URI) with influenza, respiratory syncytial virus, adenovirus, human metapneumovirus, parainfluenza virus, HRV or endemic human coronavirus (HCoV), and higher mortality or fewer DAOH. LRD caused by any respiratory virus, including just HRV, among myeloablative conditioning-treated allogeneic recipients correlated with higher overall mortality and fewer DOAH. There was no association between pretransplant URI from HRV and endemic HCoV and these outcomes, the researchers report.

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