Table 3.
Risk factor analysis for all-cause mortality in allo-HSCT recipients
| Characteristic | All-cause mortality (n = 44) | Survival (n = 236) | COR (95% CI) | P value | AOR (95% CI) | P value |
|---|---|---|---|---|---|---|
| Age (years), median (range)a | 50 (14–70) | 47 (3–68) | 1.29 (1.0, 1.66) | 0.046 | 1.45 (1.1, 1.9) | 0.008 |
| Male sex | 33 (75) | 125 (53) | 2.66 (1.29, 5.52) | 0.008 | 2.76 (1.25, 6.09) | 0.012 |
| Non-white race | 16 (36) | 83 (35) | 1.05 (0.54, 2.06) | 0.879 | — | — |
| Corticosteroidsb | 28 (64) | 113 (48) | 1.9 (0.98, 3.7) | 0.058 | — | — |
| Myeloablative conditioning regimen | 18 (41) | 99 (42) | 0.96 (0.49, 1.84) | 0.898 | — | — |
| Time from HSCT (days), median (range)a | 91 (1–1426) | 173 (1–2167) | 0.94 (0.9, 0.98) | 0.008 | 0.94 (0.9, 0.99) | 0.012 |
| Donor relationship | — | — | ||||
| matched related | 27 (61) | 131 (56) | 1.0 | |||
| matched unrelated | 14 (32) | 98 (42) | 0.69 (0.35, 1.39) | 0.302 | ||
| mismatched | 3 (7) | 7 (3) | 2.08 (0.51, 8.56) | 0.310 | ||
| Haematopoietic cell source | — | — | ||||
| marrow | 12 (27) | 64 (27) | 1.0 | |||
| peripheral | 31 (71) | 159 (67) | 1.04 (0.5, 2.15) | 0.916 | ||
| cord | 1 (2) | 13 (6) | 0.41 (0.05, 3.44) | 0.411 | ||
| GVHD at the time of diagnosis of RSV infection | 27 (61) | 153 (65) | 0.86 (0.44, 1.67) | 0.66 | — | — |
| Neutropenia (ANC <500/μL)c | 8 (18) | 7 (3) | 7.27 (2.48, 21.27) | <0.001 | 3.21 (0.91, 11.33) | 0.069d |
| Lymphocytopenia (ALC <200/μL)c | 17 (39) | 31 (13) | 4.16 (2.04, 8.51) | <0.001 | 3.03 (1.33, 6.91) | 0.008 |
| Pulmonary coinfectionse | ||||||
| viral | 3 (7) | 10 (4) | 2.12 (0.55, 8.14) | 0.274 | — | — |
| bacterial | 8 (18) | 6 (3) | 9.42 (3.06, 29.03) | <0.001 | — | — |
| fungal | 3 (7) | 8 (3) | 2.65 (0.67, 10.54) | 0.167 | — | — |
| Nosocomial infection | 7 (16) | 23 (10) | 1.75 (0.7, 4.38) | 0.230 | — | — |
| LRTI at presentation | 17 (39) | 26 (11) | 5.09 (2.45, 10.56) | <0.001 | — | — |
| Lack of antiviral therapy at the URTI stagef | 27 (61) | 96 (41) | 2.32 (1.2, 4.48) | 0.013 | 2.43 (1.16, 5.11) | 0.019 |
| Year of RSV diagnosis (2001 and later) | 35 (80) | 182 (77) | 1.15 (0.52, 2.55) | 0.724 | 1.33 (0.55, 3.24) | 0.532d |
COR, crude OR.
aMeasure of effect for age and time from HSCT expressed per 10 year and 30 day interval, respectively.
bWithin 1 month before RSV diagnosis.
cAt the time of first assessment of respiratory symptoms at the hospital.
dNeutropenia was retained in the model due to confounding effects and year of RSV diagnosis was included in the model to adjust for the overall advances in the clinical management of patients during recent years.
eWithin 1 month prior to and after RSV diagnosis. In cases of LRTI, coinfections occurred on the same day as RSV diagnosis or within 2 weeks prior to RSV LRTI. Viral coinfections included influenza virus (7), parainfluenza virus (3), picornavirus (2) and adenovirus (1); bacterial coinfections included Klebsiella oxytoca (1), Pseudomonas aeruginosa and Pseudomonas fluorescens (4), methicillin-resistant Staphylococcus aureus (2), Stenotrophomonas maltophilia (6) and Escherichia coli (1); and fungal coinfections included 8 Aspergillus spp. and 3 Nocardia spp. infections.
fRibavirin alone or combined with IVIG or palivizumab.