TABLE 1.
Characteristics and Outcomes of 181 Patients With Cancer and Human Metapneumovirus Infections
| No. of Patients (%) | ||||
|---|---|---|---|---|
| Characteristic | Solid Tumors |
HCT, Remission |
HM | Total |
| Total cohort | 34 (19) | 57 (31) | 90 (50) | 181 (100) |
| Age: Median [range] y | 62 [3-86] | 56 [16-76] | 59 [1-88] |
59 [1-88] |
| Sex | ||||
| Male | 16 (47) | 30 (53) | 63 (70) | 109 (60) |
| Female | 18 (53) | 27 (47) | 27 (30) | 72 (40) |
| Racea | ||||
| Non-Hispanic white | 16 (47) | 36 (63) | 59 (66) | 111 (61) |
| Hispanic | 11 (32) | 12 (21) | 16 (18) | 39 (22) |
| Black | 5 (15) | 6 (11) | 8 (9) | 19 (11) |
| Asian | 1 (3) | 2 (3) | 2 (2) | 5 (3) |
| Other | 1 (3) | 1 (2) | 4 (4) | 6 (3) |
| Smokinga | ||||
| Never smoker | 22 (65) | 40 (70) | 64 (71) | 126 (70) |
| Former smoker | 11 (32) | 16 (28) | 22 (24) | 49 (27) |
| Current smoker | 1 (3) | 1 (2) | 3 (3) | 5 (3) |
| Type of malignancy | ||||
| AML | 0 (0) | 12 (21) | 14 (16) | 26 (14) |
| ALL | 0 (0) | 9 (16) | 13 (14) | 22 (12) |
| CML | 0 (0) | 2 (4) | 6 (7) | 8 (4) |
| CLL | 0 (0) | 3 (5) | 4 (4) | 7 (4) |
| Hodgkin lymphoma | 0 (0) | 1 (2) | 5 (6) | 6 (3) |
| NHL | 0 (0) | 11 (19) | 10 (11) | 21 (12) |
| MDS | 0 (0) | 2 (4) | 4 (4) | 6 (3) |
| MM | 0 (0) | 14 (25) | 30 (33) | 44 (24) |
| AA | 0 (0) | 2 (4) | 0 (0) | 2 (1) |
| Other | 34 (100) | 1 (2) | 4 (4 | 39 (22) |
| Type of HCT | ||||
| None | 34 (100) | 0 | 64 (71) | 98 (54) |
| MRD | 0 (0) | 20 (35) | 2 (2) | 22 (12) |
| MUD | 0 (0) | 16 (28) | 3 (33) | 19 (10) |
| Haploidentical | 0 (0) | 3 (5) | 1 (1) | 4 (2) |
| Cord | 0 (0) | 2 (4) | 2 (2) | 4 (2) |
| Mismatched | 0 (0) | 1 (2) | 0 | 1 (1) |
| Autologous | 0 (0) | 15 (26) | 18 (20) | 33 (18) |
| HCT cell source | ||||
| Bone marrow | 0 (0) | 7 (12) | 0 (0) | 7 (4) |
| Cord | 0 (0) | 2 (4) | 2 (2) | 4 (2) |
| Peripheral | 0 (0) | 48 (84) | 24 (27) | 72 (40) |
| Type of infection | ||||
| Community-acquired | 32 (94) | 52 (91) | 82 (91) | 166 (92) |
| Nosocomial | 2 (6) | 5 (9) | 8 (9) | 15 (8) |
| Site of infection at the time of presentation | ||||
| URI | 25 (74) | 43 (75) | 54 (60) | 122 (67) |
| LRI | 9 (26) | 14 (25) | 36 (40) | 59 (33) |
| Progression from URI to LRI | ||||
| No | 24 (71) | 38 (67) | 41 (46) | 103 (57) |
| Yes | 1 (3) | 5 (9) | 13 (14) | 19 (10) |
| Time to progression from URI to LRI: Median [range], db |
1 | 12 [1-30] | 8 [1-30] | 8 [1-30] |
| Overall LRI | ||||
| No | 24 (71) | 38 (67) | 41 (46) | 103 (57) |
| Yes | 10 (29) | 19 (34) | 49 (54) | 78 (43) |
| Steroids within 30 d before hMPV | ||||
| No | 25 (74) | 39 (70) | 52 (58) | 116 (64) |
| Yes | 9 (26) | 18 (32) | 38 (42) | 65 (36) |
| Lymphopeniaa | ||||
| No | 31 (91) | 54 (95) | 75 (83) | 160 (88) |
| Yes | 2 (6) | 3 (5) | 15 (17) | 20 (11) |
| Neutropeniaa | ||||
| No | 29 (85) | 56 (98) | 69 (77) | 154 (85) |
| Yes | 4 (12) | 1 (2) | 21 (23) | 26 (14) |
| Hypoxia at presentation | ||||
| >92% | 29 (85) | 53 (93) | 82 (91) | 164 (91) |
| ≤92% | 5 (15) | 4 (7) | 8 (9) | 17 (9) |
| Ribavirin | ||||
| URI stage | 0 | 1 (2) | 1 (1) | 2 (1) |
| LRI stage | 0 | 2 (4) | 1 (1) | 3 (2) |
| IVIG | ||||
| URI stage | 1 (3) | 7 (13) | 6 (7) | 14 (8) |
| LRI stage | 0 (0) | 3 (5) | 16 (18) | 19 (11) |
| Coinfection before hMPV | ||||
| Pulmonary | 5 (15) | 11 (19) | 15 (7) | 31 (17) |
| Extrapulmonary | 1 (3) | 1 (2) | 6 (7) | 8 (4) |
| Coinfection after hMPV | ||||
| Pulmonary | 3 (9) | 2 (4) | 4 (4) | 9 (5) |
| Extrapulmonary | 0 (0) | 1 (2) | 2 (2) | 3 (2) |
| Hospital admission secondary to infectionc | 15/29 (52) | 21/30 (70) | 44/78 (56) |
80/137 (58) |
| Length of hospital stay: Median [range], dc | 4 [2-20] | 6 [3-17] | 6 [2-29] | 6 [2-29] |
| ICU at onset | 2 (6) | 1 (2) | 1 (1) | 4 (2) |
| ICU later during the illness | 1 (3) | 1 (2) | 4 (4) | 6 (3) |
| Mechanical ventilation | 3 (9) | 2 (4) | 3 (3) | 8 (4) |
| Oxygen supplement | 10 (29) | 12 (21) | 26 (29) | 48 (27) |
| All-cause mortality, 30 d | 1 (3) | 1 (2) | 6 (7) | 8 (4) |
| All-cause mortality, 90 d | 2 (6) | 2 (4) | 8 (9) | 12 (7) |
Abbreviations: AA, aplastic anemia; ALL, acute lymphoblastic leukemia; AML, acute myelogenous leukemia; CLL, chronic lymphocytic leukemia; CML, chronic myelogenous leukemia; HCT, hematopoietic cell transplantation; HM, hematologic malignancy; hMPV, human metapneumovirus; ICU, intensive care unit; IVIG, intravenous immunoglobulin; LRI, lower respiratory tract infection; MDS, myelodysplastic syndrome; MM, multiple myeloma; MRD, matched-related donor; MUD, matched-unrelated donor; NHL, non-Hodgkin lymphoma; URI, upper respiratory tract infection.
One patient was missing information.
This analysis was restricted to patients who progressed from URI to LRI (n = 19).
Analysis of the time to progression excluded patients who were admitted before hMPV diagnosis.