Clinical characteristics of patients with human adenovirus infection undergoing allogeneic hematopoietic stem cell transplantation
10.3760/cma.j.cn112138-20220606-00434
- VernacularTitle:异基因造血干细胞移植后腺病毒感染的临床特征分析
- Author:
Tingting HAN
1
;
Yan HONG
;
Fangfang WEI
;
Yuqian SUN
;
Chenhua YAN
;
Xiaodong MO
;
Yu WANG
;
Xiaohui ZHANG
;
Lanping XU
;
Xiaojun HUANG
;
Xiaosu ZHAO
Author Information
1. 北京大学人民医院 北京大学血液病研究所 国家血液系统疾病临床医学研究中心 造血干细胞移植治疗血液病北京市重点实验室，北京 100044
- Keywords:
Adenoviruses, human;
Hematopoietic stem cell transplantation;
Allogeneic hematopoietic stem cell transplantation;
Clinical characteristic
- From:
Chinese Journal of Internal Medicine
2023;62(2):163-168
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics and prognosis of human adenovirus (HAdV) infection in patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:This is a retrospective case series study. Patients who received allo-HSCT and had symptoms of HAdV infection were tested in the Hematology Department at Perking University People′s Hospital from August 2015 to October 2019. Real-time quantitative PCR was used to detect HAdV DNA from 2 728 patients with potential infection. HAdV DNA-positive patients were defined as having HAdV infection. The clinical features of these patients were analyzed, and a case-pair method was used to select patients without HAdV infection as the control group in a 1∶3 ratio. The clinical results of the two groups were compared using Kaplan-Meier and Log-rank testing.Results:A total of 7 119 samples were tested for HAdV, of which 99 samples from 36 patients were positive. Of these patients, 22 developed HAdV viremia, and 24 patients had concurrent infection with another virus. Nineteen patients had fever (53%), 25 had gastrointestinal symptoms (69%), 11 had respiratory symptoms (31%), nine had reduced liver function (25%), and six had nervous system symptoms (17%). Twenty-three patients developed acute graft-versus-host disease of grade 2 or higher. Of all the patients with HAdV infection, nine were treated with cidofovir, seven of whom became HAdV negative and two had invalid treatment. The median follow-up time was 496 (216, 940) d post-HSCT. The overall survival at 5 years post HSCT was 48.4%±9.2% vs. 91.3%±3.5% ( χ2=65.03, P<0.001) in patients with and without HADV, respectively. The non-relapse mortality at 5 years post-HSCT was 40.8%±8.8% vs. 4.0%±2.0% ( χ2=34.17, P<0.001) in patients with and without HADV, respectively. Conclusions:After allo-HSCT, HAdV-infected patients are dominated by gastrointestinal and respiratory symptoms and have an increased risk of combined acute graft-versus-host disease of >2 degrees. Patients with HAdV infection have poor overall survival and high non-relapse mortality.
