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Erschienen in: Infection 6/2012

01.12.2012 | Brief Report

Human metapneumovirus infection after allogeneic hematopoietic stem cell transplantation

verfasst von: A. Egli, C. Bucher, A. Dumoulin, M. Stern, A. Buser, L. Bubendorf, M. Gregor, P. Servida, G. Sommer, J. Bremerich, A. Gratwohl, N. Khanna, A. F. Widmer, M. Battegay, M. Tamm, H. H. Hirsch, J. P. Halter

Erschienen in: Infection | Ausgabe 6/2012

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Abstract

Background

The clinical characteristics of human metapneumovirus (hMPV)-associated lower respiratory tract infection (LRTI) after allogeneic hematopoietic stem cell transplantation (HSCT) is not well described. We describe the clinical course in eight HSCT recipients suffering from hMPV infection.

Methods

We prospectively included all patients with hMPV-associated LRTI after allogeneic HSCT during a period of 1 year. hMPV was diagnosed by multiplex polymerase chain reaction (PCR) from bronchoalveolar lavage (BAL).

Results

Eight patients with hMPV-associated LRTI were identified from 93 BAL samples. Three of the eight patients had co-infections with other pathogens. The median age of the patients was 45 years [interquartile range (IQR) 36.8–53.5], the median time posttransplant was 473 days (IQR 251–1,165), 5/8 patients had chronic graft-versus-host disease (cGvHD), and 6/8 patients received immunosuppression. Chest computed tomography (CT) scanning showed a ground-glass pattern in 7/8 patients. Seven of eight patients required hospitalization due to severe symptoms and hypoxemia. All were treated with intravenous immunoglobulin (IVIG), which was combined with oral ribavirin in six patients. The mortality rate was 12.5 % (1/8).

Conclusions

hMPV-associated LRTI in allogeneic HSCT recipients are not uncommon and present with unspecific respiratory symptoms, ground-glass pattern in CT scanning, and co-infection.
Literatur
1.
Zurück zum Zitat Boeckh M. The challenge of respiratory virus infections in hematopoietic cell transplant recipients. Br J Haematol. 2008;143:455–67.PubMed Boeckh M. The challenge of respiratory virus infections in hematopoietic cell transplant recipients. Br J Haematol. 2008;143:455–67.PubMed
2.
Zurück zum Zitat Anderson EJ. Viral diagnostics and antiviral therapy in hematopoietic stem cell transplantation. Curr Pharm Des. 2008;14:1997–2010.PubMedCrossRef Anderson EJ. Viral diagnostics and antiviral therapy in hematopoietic stem cell transplantation. Curr Pharm Des. 2008;14:1997–2010.PubMedCrossRef
3.
Zurück zum Zitat Ison MG. Respiratory viral infections in transplant recipients. Antivir Ther. 2007;12:627–38PubMed Ison MG. Respiratory viral infections in transplant recipients. Antivir Ther. 2007;12:627–38PubMed
4.
Zurück zum Zitat van den Hoogen BG, de Jong JC, Groen J, et al. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med. 2001;7:719–24.PubMedCrossRef van den Hoogen BG, de Jong JC, Groen J, et al. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med. 2001;7:719–24.PubMedCrossRef
5.
Zurück zum Zitat Chatzidimitriou D, Gavriilaki E, Sakellari I, Diza E. Hematopoietic cell transplantation and emerging viral infections. J Med Virol. 2010;82:528–38.PubMedCrossRef Chatzidimitriou D, Gavriilaki E, Sakellari I, Diza E. Hematopoietic cell transplantation and emerging viral infections. J Med Virol. 2010;82:528–38.PubMedCrossRef
6.
Zurück zum Zitat Papenburg J, Boivin G. The distinguishing features of human metapneumovirus and respiratory syncytial virus. Rev Med Virol. 2010;20:245–60.PubMedCrossRef Papenburg J, Boivin G. The distinguishing features of human metapneumovirus and respiratory syncytial virus. Rev Med Virol. 2010;20:245–60.PubMedCrossRef
7.
Zurück zum Zitat Ljungman P, Ward KN, Crooks BN, et al. Respiratory virus infections after stem cell transplantation: a prospective study from the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant. 2001;28:479–84.PubMedCrossRef Ljungman P, Ward KN, Crooks BN, et al. Respiratory virus infections after stem cell transplantation: a prospective study from the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant. 2001;28:479–84.PubMedCrossRef
8.
Zurück zum Zitat Khanna N, Widmer AF, Decker M, et al. Respiratory syncytial virus infection in patients with hematological diseases: single-center study and review of the literature. Clin Infect Dis. 2008;46:402–12.PubMedCrossRef Khanna N, Widmer AF, Decker M, et al. Respiratory syncytial virus infection in patients with hematological diseases: single-center study and review of the literature. Clin Infect Dis. 2008;46:402–12.PubMedCrossRef
9.
Zurück zum Zitat Dumoulin A, Widmer AF, Hirsch HH. Comprehensive diagnostics for respiratory virus infections after transplantation or after potential exposure to swine flu A/H1N1: what else is out there? Transpl Infect Dis. 2009;11:287–9.PubMedCrossRef Dumoulin A, Widmer AF, Hirsch HH. Comprehensive diagnostics for respiratory virus infections after transplantation or after potential exposure to swine flu A/H1N1: what else is out there? Transpl Infect Dis. 2009;11:287–9.PubMedCrossRef
10.
Zurück zum Zitat Reijans M, Dingemans G, Klaassen CH, et al. RespiFinder: a new multiparameter test to differentially identify fifteen respiratory viruses. J Clin Microbiol. 2008;46:1232–40.PubMedCrossRef Reijans M, Dingemans G, Klaassen CH, et al. RespiFinder: a new multiparameter test to differentially identify fifteen respiratory viruses. J Clin Microbiol. 2008;46:1232–40.PubMedCrossRef
11.
Zurück zum Zitat Bonney D, Razali H, Turner A, Will A. Successful treatment of human metapneumovirus pneumonia using combination therapy with intravenous ribavirin and immune globulin. Br J Haematol. 2009;145:667–9.PubMedCrossRef Bonney D, Razali H, Turner A, Will A. Successful treatment of human metapneumovirus pneumonia using combination therapy with intravenous ribavirin and immune globulin. Br J Haematol. 2009;145:667–9.PubMedCrossRef
12.
Zurück zum Zitat Russmann S, Grattagliano I, Portincasa P, Palmieri VO, Palasciano G. Ribavirin-induced anemia: mechanisms, risk factors and related targets for future research. Curr Med Chem. 2006;13:3351–7.PubMedCrossRef Russmann S, Grattagliano I, Portincasa P, Palmieri VO, Palasciano G. Ribavirin-induced anemia: mechanisms, risk factors and related targets for future research. Curr Med Chem. 2006;13:3351–7.PubMedCrossRef
13.
Zurück zum Zitat Campbell AP, Chien JW, Kuypers J, et al. Respiratory virus pneumonia after hematopoietic cell transplantation (HCT): associations between viral load in bronchoalveolar lavage samples, viral RNA detection in serum samples, and clinical outcomes of HCT. J Infect Dis. 2010;201:404–13.CrossRef Campbell AP, Chien JW, Kuypers J, et al. Respiratory virus pneumonia after hematopoietic cell transplantation (HCT): associations between viral load in bronchoalveolar lavage samples, viral RNA detection in serum samples, and clinical outcomes of HCT. J Infect Dis. 2010;201:404–13.CrossRef
14.
Zurück zum Zitat Debur MC, Vidal LR, Stroparo E, et al. Human metapneumovirus infection in hematopoietic stem cell transplant recipients. Transpl Infect Dis. 2010;12:173–9.PubMedCrossRef Debur MC, Vidal LR, Stroparo E, et al. Human metapneumovirus infection in hematopoietic stem cell transplant recipients. Transpl Infect Dis. 2010;12:173–9.PubMedCrossRef
15.
Zurück zum Zitat Oliveira R, Machado A, Tateno A, Boas LV, Pannuti C, Machado C. Frequency of human metapneumovirus infection in hematopoietic SCT recipients during 3 consecutive years. Bone Marrow Transplant. 2008;42:265–9.PubMedCrossRef Oliveira R, Machado A, Tateno A, Boas LV, Pannuti C, Machado C. Frequency of human metapneumovirus infection in hematopoietic SCT recipients during 3 consecutive years. Bone Marrow Transplant. 2008;42:265–9.PubMedCrossRef
16.
Zurück zum Zitat Cane PA, van den Hoogen BG, Chakrabarti S, Fegan CD, Osterhaus AD. Human metapneumovirus in a haematopoietic stem cell transplant recipient with fatal lower respiratory tract disease. Bone Marrow Transplant. 2003;31:309–10.PubMedCrossRef Cane PA, van den Hoogen BG, Chakrabarti S, Fegan CD, Osterhaus AD. Human metapneumovirus in a haematopoietic stem cell transplant recipient with fatal lower respiratory tract disease. Bone Marrow Transplant. 2003;31:309–10.PubMedCrossRef
17.
Zurück zum Zitat Englund JA, Boeckh M, Kuypers J, et al. Brief communication: fatal human metapneumovirus infection in stem-cell transplant recipients. Ann Intern Med. 2006;144:344–9.PubMed Englund JA, Boeckh M, Kuypers J, et al. Brief communication: fatal human metapneumovirus infection in stem-cell transplant recipients. Ann Intern Med. 2006;144:344–9.PubMed
18.
Zurück zum Zitat Franquet T, Rodríguez S, Martino R, Salinas T, Giménez A, Hidalgo A.. Human metapneumovirus infection in hematopoietic stem cell transplant recipients: high-resolution computed tomography findings. J Comput Assist Tomogr. 2005;29:223–7.PubMedCrossRef Franquet T, Rodríguez S, Martino R, Salinas T, Giménez A, Hidalgo A.. Human metapneumovirus infection in hematopoietic stem cell transplant recipients: high-resolution computed tomography findings. J Comput Assist Tomogr. 2005;29:223–7.PubMedCrossRef
19.
Zurück zum Zitat Huck B, Egger M, Bertz H, et al. Human metapneumovirus infection in a hematopoietic stem cell transplant recipient with relapsed multiple myeloma and rapidly progressing lung cancer. J Clin Microbiol. 2006;44:2300–3.PubMedCrossRef Huck B, Egger M, Bertz H, et al. Human metapneumovirus infection in a hematopoietic stem cell transplant recipient with relapsed multiple myeloma and rapidly progressing lung cancer. J Clin Microbiol. 2006;44:2300–3.PubMedCrossRef
20.
Zurück zum Zitat Ison MG, Hayden FG. Viral infections in immunocompromised patients: what’s new with respiratory viruses? Curr Opin Infect Dis. 2002;15:355–67.PubMedCrossRef Ison MG, Hayden FG. Viral infections in immunocompromised patients: what’s new with respiratory viruses? Curr Opin Infect Dis. 2002;15:355–67.PubMedCrossRef
21.
Zurück zum Zitat Lacey SF, Diamond DJ, Zaia JA. Assessment of cellular immunity to human cytomegalovirus in recipients of allogeneic stem cell transplants. Biol Blood Marrow Transplant. 2004;10:433–47.PubMedCrossRef Lacey SF, Diamond DJ, Zaia JA. Assessment of cellular immunity to human cytomegalovirus in recipients of allogeneic stem cell transplants. Biol Blood Marrow Transplant. 2004;10:433–47.PubMedCrossRef
22.
Zurück zum Zitat Safdar A. Immune modulatory activity of ribavirin for serious human metapneumovirus disease: early i.v. therapy may improve outcomes in immunosuppressed SCT recipients. Bone Marrow Transplant. 2008;41:707–8.PubMedCrossRef Safdar A. Immune modulatory activity of ribavirin for serious human metapneumovirus disease: early i.v. therapy may improve outcomes in immunosuppressed SCT recipients. Bone Marrow Transplant. 2008;41:707–8.PubMedCrossRef
23.
Zurück zum Zitat Fischer SA. Emerging viruses in transplantation: there is more to infection after transplant than CMV and EBV. Transplantation. 2008;86:1327–39.PubMedCrossRef Fischer SA. Emerging viruses in transplantation: there is more to infection after transplant than CMV and EBV. Transplantation. 2008;86:1327–39.PubMedCrossRef
24.
Zurück zum Zitat Hamelin ME, Prince GA, Boivin G. Effect of ribavirin and glucocorticoid treatment in a mouse model of human metapneumovirus infection. Antimicrob Agents Chemother. 2006;50:774–7.PubMedCrossRef Hamelin ME, Prince GA, Boivin G. Effect of ribavirin and glucocorticoid treatment in a mouse model of human metapneumovirus infection. Antimicrob Agents Chemother. 2006;50:774–7.PubMedCrossRef
25.
Zurück zum Zitat Filipovich AH, Weisdorf D, Pavletic S, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant. 2005;11:945–56.PubMedCrossRef Filipovich AH, Weisdorf D, Pavletic S, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant. 2005;11:945–56.PubMedCrossRef
Metadaten
Titel
Human metapneumovirus infection after allogeneic hematopoietic stem cell transplantation
verfasst von
A. Egli
C. Bucher
A. Dumoulin
M. Stern
A. Buser
L. Bubendorf
M. Gregor
P. Servida
G. Sommer
J. Bremerich
A. Gratwohl
N. Khanna
A. F. Widmer
M. Battegay
M. Tamm
H. H. Hirsch
J. P. Halter
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
Infection / Ausgabe 6/2012
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-012-0279-9

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