Incidence and predictors of respiratory viral infections by multiplex PCR in allogeneic hematopoietic cell transplant recipients 50 years and older including geriatric assessment

Abstract

Community respiratory viruses (CRV) are important agents of morbidity and mortality within the allogeneic hematopoietic stem cell transplant (HCT) population. Few proven methods to prevent CRV infections exist. No studies have specifically investigated their impact on older patients. We reviewed patients 50 years and older undergoing HCT between 2009–2013 to determine the incidence of CRV infection using multiplex PCR and risk factors for infection including geriatric assessment (GA). Thirty-two first episode CRV infections occurred in 118 patients for a 1-year cumulative incidence of 27.2% (CI: 19.4–35.6%). Hospitalization and mortality were restricted to those who developed lower respiratory tract infections (LRTI) (n = 22, 69%). CRV infection contributed to 8 deaths (36% of LRTIs) and 7 of these patients were taking steroids for GvHD at the time of infection. Health impairments by GA did not translate into increased risk for CRV infection. Steroid use at time of LRTI was associated with high mortality.

Keywords:

• respiratory viruses
• hematopoietic cell transplantation
• incidence
• geriatric assessment

Acknowledgements

The authors have no additional acknowledgements to make at the time of manuscript submission.

Potential conflict of interest

Dr. Artz receives financial support from Miltenyi Biotech. Dr. Liu receives financial support from AstraZeneca/Medimmune and Pfizer outside the submitted work. Dr. Godley receives financial support from Onconova outside the submitted work. Dr. Kocherginsky has a patent US8710035B2 licensed to Corcept and has received $0 in royalties as of 8/18/15. These funding sources have not had any input on any part of the research study including but not limited to project design, objectives, data collection, manuscript preparation, or submission decisions. Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.3109/10428194.2015.1113279.