Table 3.
Clinical and biological characteristics of respiratory virus infection episodes in allo-HSCT recipients according to prospective clinical CARV survey vs. retrospective standard clinical practice.
| Prospective CARV | Retrospective CARV | p value | |
|---|---|---|---|
| (n = 297) | (n = 108) | ||
| Immunodeficiency Scoring Index, n (%)a | |||
| ANC < 0.5 × 109/L (3pts) | 21 (7) | 18 (17) | 0.007 |
| ALC< 0.2 × 109/L (3pts) | 41 (14) | 35 (32) | <0.0001 |
| Age ≥ 40 y (2pts) | 181 (62) | 67 (62) | 0.9 |
| Myeloablative conditioning regimen (1pt) | 182 (61) | 85 (78) | 0.001 |
| GvHD (acute or chronic; 1pt) | 126 (42) | 79 (73) | <0.0001 |
| Corticosteroids (1pt) | 92 (31) | 91 (86) | <0.0001 |
| Recent or pre-engraftment allo-HCT (1pt) | 27 (9) | 21 (19) | 0.008 |
| ISI, n (%) | <0.0001 | ||
| • Low risk (0–2) | 114 (38) | 10 (9) | |
| • Moderate risk (3–6) | 160 (54) | 68 (63) | |
| • High risk (7–12) | 23 (8) | 30 (28) | |
| Other characteristicsa | |||
| On IS, n (%) | 213 (71) | 101 (94) | <0.0001 |
| ALC< 0.1 × 109/L, n (%) | 30 (10) | 19 (18) | 0.06 |
| ALC < 0.5 × 109/L, n (%) | 73 (25) | 49 (45) | 0.001 |
| RVI characteristics and clinical consequences | |||
| CARV LRTD, n (%) | 93 (31) | 63 (58) | <0.0001 |
| • Possible | 41 (49) | 32 (51) | |
| • Proven | 52 (51) | 31 (49) | |
| Hospital admission, n (%) | 82 (28) | 75 (69) | <0.0001 |
| Antiviral therapy, n (%) | 69 (23) | 43 (40) | 0.002 |
| • URTD | 34 | 12 | |
| • LRTD | 35 | 31 | |
| • HPiVb | 9 | 1 | |
| ∘ URTD/LRTD | 1 / 8 | 0 / 1 | |
| • RSVb | 22 | 21 | |
| ∘ URTD/LRTD | 11 / 11 | 3 / 18 | |
| • Influenzab | 46 | 25 | |
| ∘ URTD/LRTD | 29 / 17 | 10 / 15 | |
| • hMPVb | 5 | 4 | |
| ∘ URTD/LRTD | 2 / 3 | 0 / 4 | |
| CARV during the first year of allo-HCT, n (%) | 108 (36) | 39 (33) | 1 |
| Fever during CARV, n (%) | 169 (57) | 90 (83) | <0.0001 |
| Co-virus infection | 45 (15) | 21 (19) | 0.3 |
| Bronchoalveolar lavage | 59 (20) | 39 (36) | 0.001 |
| Co-bacterial pneumonia | 15 (5) | 10 (9) | 0.1 |
| Seasonal influenza vaccination | 79 (27) | 3 (3) | <0.0001 |
| Day + 30 overall mortality rate, n (%) | 2 (0.6) | 11 (10) | <0.0001 |
| Day + 60 overall mortality rate, n (%) | 4 (1.2) | 18 (17) | <0.0001 |
| Day + 90 overall mortality rate, n (%) | 10 (3) | 23 (21) | <0.0001 |
Abbreviations: CARV, community-acquired respiratory virus; IFD, invasive pulmonary infectious fungal disease; ATG, anti-thymocyte globulin; GvHD, graft-versus-host disease; ANC, absolute neutrophil count; ALC, absolute lymphocyte count; IS, immunosuppressants; LRTD, lower respiratory tract disease; URTD, upper respiratory tract disease; HPiV, human parainfluenza virus; RSV, respiratory syncytial virus; hMPV, human metapneumovirus; Allo-HCT, allogeneic hematopoietic stem cell transplantation;.
All variables were captured at the time of CARV diagnosis.
The sum total antiviral therapies do not match the overall number of antiviral therapies since multiple CARVs were detected in the same respiratory sample.