Table 1.
Summary of Clinical Parameters
| Patient 1 | Patient 2 | Patient 3 | Patient 4 | |
|---|---|---|---|---|
| Age/sex | 12-year-old male | 7-month-old male | 4-year-old male | 3-year-old male |
| Underlying disease | Relapsed ALL | SCID | Stage IV neuroblastoma | AML |
| Transplant type | Double cord | Single cord | Autologous | MURD |
| PIV onset | URTI: TxD+260 LRTI: TxD+275 |
URTI: TxD-71 LRTI: TxD+2 |
URTI: TxD-26 LRTI: TxD-25 |
URTI: TxD+2 |
| PIV type | PIV-3 | PIV-2 | PIV-3 | PIV-3 |
| Symptoms | New O2 requirement, ↑respiratory distress | ↑FiO2, fever, wheezing | ↑Cough, fever, crackles | Cough, rhinorrhea |
| Radiographic findings | Ground-glass opacities on CXR/CT | ↑infiltrates on CXR/CT | New infiltrates on CXR/CT | |
| Co-pathogens | Adenovirus and hMPV (at time of URTI), HRV and adenovirus (at time of LRTI) | None | None | HRV |
| DAS181 treatment | 10 mg/day × 10 days (dry powder) |
0.14 mg/kg per day × 2 days, then 0.2 mg/kg per day × 3 days (nebulized) | 0.14 mg/kg per day × 2 days, then 0.2 mg/kg per day × 3 days (nebulized) | 0.14 mg/kg per day × 10 days (nebulized) |
| WBC (cells/µL) | ||||
| Start of therapy | 2800 | <200 | 9300 | <200 |
| Minimum while on therapy | 2800 | <200 | 3500 | <200 |
| End of therapy | 4700 | <200 | 3500 | <200 |
| Absolute neutrophil count (cells/µL) | ||||
| Start of therapy | 2120 | <200 | 6426 | <200 |
| Minimum while on therapy | 1988 | <200 | 1820 | <200 |
| End of therapy | 3660 | <200 | 1820 | <200 |
| Absolute lymphocyte count (cells/µL) | ||||
| Start of therapy | 440 | <200 | 1256 | <200 |
| Minimum while on therapy | 372 | <200 | 402 | <200 |
| End of therapy | 752 | <200 | 830 | <200 |
| Absolute monocyte count (cells/µL) | ||||
| Start of therapy | 210 | <200 | 1218 | <200 |
| Minimum while on therapy | 140 | <200 | 536 | <200 |
| End of therapy | 282 | <200 | 584 | <200 |
| Maximum alkaline phosphatase, IU/L (normal range) | 477 (135–530) | 298 (95–380) | 598 (95–380) | 247 (95–380) |
| Maximum alanine aminotransferase, IU/L (normal range) | 126 (10–50) | 35 (6–45) | 73 (6–40) | 152 (6–40) |
| Maximum aspartate aminotransferase, IU/L (normal range) | 105 (5–41) | 48 (3–74) | 86 (5–41) | 146 (5–41) |
| Maximum PTT, s (normal range) | 30 (25–35) | 51 (25–35) | 90 (25–35) | 47 (25–35) |
| Maximum INR | 0.9 | 1.9 | 1.2 | 1.2 |
Abbreviations: ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; CT, computerized tomography; CXR, chest x-ray; hMPV, human metapneumovirus; HRV, human rhinovirus; INR, International normalized ratio; LRTI, lower respiratory tract infection; MURD, matched unrelated donor; PIV, parainfluenza virus; PTT, partial thromboplastin time; SCID, severe combined immunodeficiency; TxD, transplant day; URTI, upper respiratory tract infection; WBC, white blood cells.