Table 3.
Detailed characteristics and outcomes among recipients with human adenovirus (HAdV) infection (n = 12)
| Case No. | Age/Sex | UD | Donor/Source | Max acute GVHD | Max chronic GVHD | Relapseda | Co‐infectionsb | HAdV infection‐associated characteristics | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Onset (day) | Specimen (type with species)c | ALC (/μL) | Max copies (/mL) | Symptom/Disease status | Antiviral treatment | Outcome | ||||||||
| Viremia, n = 4 | ||||||||||||||
| 016 | 17/F | AA | MRD/PB | 2 | E | No | CMV, BKV | 270, 278 | B (B3), S (C1) | 250 | 1800 | Melena | No | Resolved |
| 031 | 9/M | ALL | MUD/PB | 1 | E | Yes | CMV, BKV, RSV, NoV, IFI, | 591, 596 | R, B (B3) | 90 | 191 000 | Pneumonia | Yes | Deathe |
| 038‐2d | 3/F | AML | MRD/PB | 2 | 0 | Yes | CMV, IFI | 7, 16 | B (B3), U | 330 | 9300 | Hematuria | No | Resolved |
| 047 | 6/F | NBL | MMRD/PB | 2 | E | Yes | CMV, BKV, RSV, IFI | 172, 172, 252 | B (B3), R, S (B3) | 270 | 2000 | Pneumonia | Yes | Deathf |
| Non‐viremia, n = 8 | ||||||||||||||
| 002 | 20 mo/M | CGD | MUD/PB | 3 | 0 | No | CMV, EBV | 42 | U (B35) | 690 | N/A | Hematuria | No | Resolved |
| 018 | 10/M | AA | MUD/CB | 1 | 0 | No | CMV, EBV, PIV | 219 | R | 3610 | N/A | Sinusitis | No | Resolved |
| 028 | 8 mo/M | ALL | MRD/PB | 1 | L | Yes | No | 102 | S (C2) | 1620 | N/A | Diarrheal | No | Resolved |
| 038‡ | 2/F | AML | MRD/PB | 1 | 0 | No | CMV, RSV | 53 | S | 380 | N/A | Diarrheal | No | Resolved |
| 039 | 2/F | AML | MUD/PB | 0 | 0 | No | No | 15 | S (F41) | 210 | N/A | No | No | Resolved |
| 042 | 7/M | NBL | MUD/PB | 1 | L | Yes | BKV, HCoRV | 124 | R | 1390 | N/A | Nog | No | Resolved |
| 051 | 5/M | NBL | MMRD/PB | 2 | 0 | Yes | No | 301 | R | 730 | N/A | URTI | Yes | Resolved |
| 059 | 5/F | AML | MUD/CB | 3 | 0 | Yes | CMV, BKV | 50, 56 | S (A31), S (C1) | 1250 | N/A | Diarrheal | No | Resolved |
HAdV indicates human adenovirus; UD, underlying disease; GVHD, graft‐vs‐host disease; ALC, absolute lymphocyte count; AML, acute myeloid leukemia; NBL, neuroblastoma; AA, aplastic anemia; ALL, acute lymphoblastic leukemia; CGD, chronic granulomatous disease; MRD, matched related donor; MUD, matched unrelated donor; MMRD, mismatched related donor; PB, peripheral blood; CB, cord blood; E, extensive; L, localized; CMV, cytomegalovirus; IFI, invasive fungal infection; BKV, BK virus; RSV, respiratory syncytial virus; NoV, norovirus; EBV, Epstein–Barr virus; HCoRV, human coronavirus; PIV, parainfluenza virus; B, blood; U, urine, R, respiratory; S, stool; N/A, not applicable; URTI, upper respiratory tract infection.
The relapsed state is defined as a return of a malignant disease or the signs and symptoms of a disease after a period of improvement.
Co‐infection was defined as any infection caused by other pathogens in addition to HAdV before and after 7 days of HAdV‐positive period.
Cases without virus‐type information are presented as only sample types. Types are written as HAdV X (species) Y (type).
This recipient had received allogeneic hematopoietic cell transplantation (HCT) twice. The case No. 038 indicates the HAdV infection after 1st HCT, and the case No. 038‐2 indicates another HAdV infection after the 2nd HCT.
This recipient died due to progression of severe pneumonia with underlying poorly controlled extensive chronic GVHD. He also had RSV, CMV with antigenemia (maximum titer: 74/200 000 WBCs) and HAdV infections. RSV and HAdV were detected in respiratory specimens, but only HAdV was detected in blood specimens with very high titers (19 000 copies/mL) at the time of death. CMV was well‐controlled by antiviral management (0/200 000 WBCs at the time of death).
This recipient died due to progression of severe pneumonia with underlying poorly controlled extensive chronic GVHD. RSV and HAdV were detected in respiratory specimens, ut HAdV was the only pathogen detected in blood specimen at the time of death. Further study on HAdV titer in this patient could not be performed because research sample collections during the period of disease progression were not available owing to an outbreak of Middle‐East respiratory syndrome coronavirus (MERS‐CoV) at our center in 2015.31
This recipient was admitted to the hospital due to anemia and developed fever during red blood cell transfusion. Respiratory multiplex PCR was performed as a routine care practice.
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