Τίτλος:
Epidemiology of viral infections among children undergoing hematopoietic stem cell transplant: Α prospective single-center study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Viral infections are a significant cause of morbidity and mortality in pediatric transplant populations. We analyzed the epidemiology of viral infections in pediatric hematopoietic stem cell transplant (HSCT) patients, including their incidence, associated risk factors, and outcome. Methods: In a prospective study from September 2011 to September 2015, blood, urine, and stool specimens were monitored weekly from transplantation to day 100 or after if clinically suspected, by use of real-time polymerase chain reaction. Cytomegalovirus (CMV), Epstein-Barr virus (EBV), BK polyomavirus (BKV), Herpes simplex virus-1,2, Varicella zoster virus, Human herpes virus-6,7, and Adenovirus infections were monitored. All children and adolescents who underwent HSCT received long-term follow up in the regular outpatient clinics (range 2-48 months). Results: A total of 192 HSCTs (autologous/allogeneic: 53/139) were performed in 165 subjects (median age: 5.6 years). Viruses most commonly isolated were CMV (46.1%), BKV (25.9%) and EBV (22.6%) and were more frequent in allogeneic versus autologous transplants (P < 0.05). Almost all high-risk allogeneic recipients developed EBV infections post-HSCT. EBV-PTLD was the only cause of death among those who developed viral disease. The factors significantly associated with the development of viral infections were recipient's advanced age, unrelated donor, mismatched graft and use of peripheral blood stem cells grafts. Conclusions: Viral infections were common among our pediatric recipients. Data suggest that monitoring of viral load may be significant to the prevention of viral disease. Particular demographic and transplantation characteristics were associated with the development of viral infections post-HSCT. © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Συγγραφείς:
Tsoumakas, K.
Giamaiou, K.
Goussetis, E.
Graphakos, S.
Kossyvakis, A.
Horefti, E.
Mentis, A.
Elefsiniotis, I.
Pavlopoulou, I.D.
Περιοδικό:
Transplant Infectious Disease
Εκδότης:
Blackwell Publishing Inc.
Λέξεις-κλειδιά:
Adenoviridae; adenovirus infection; adolescent; age; allogeneic hematopoietic stem cell transplantation; Article; autologous hematopoietic stem cell transplantation; BK virus; cause of death; chickenpox; child; cohort analysis; Cytomegalovirus; cytomegalovirus infection; Epstein Barr virus; Epstein Barr virus infection; female; follow up; graft recipient; hematopoietic stem cell transplantation; herpes simplex; Herpes simplex virus 2; herpes virus infection; high risk patient; human; Human alphaherpesvirus 1; Human herpesvirus 6; Human herpesvirus 7; incidence; major clinical study; male; nonhuman; outcome assessment; peripheral blood stem cell transplantation; posttransplant lymphoproliferative disease; priority journal; prospective study; real time polymerase chain reaction; risk factor; unrelated donor; Varicella zoster virus; virus infection; virus isolation; virus load; adenovirus infection; adverse event; allotransplantation; blood; cytomegalovirus infection; Epstein Barr virus infection; hematopoietic stem cell transplantation; infant; preschool child; virus activation; virus infection, virus DNA, Adenoviridae Infections; Adolescent; Child; Child, Preschool; Cytomegalovirus Infections; DNA, Viral; Epstein-Barr Virus Infections; Female; Hematopoietic Stem Cell Transplantation; Humans; Infant; Male; Prospective Studies; Risk Factors; Transplantation, Homologous; Viral Load; Virus Activation; Virus Diseases
