Characteristics of HCT recipients with influenza virus respiratory tract disease
| Characteristics . | Virus type . | All patients (N = 161) . | ||
|---|---|---|---|---|
| Influenza A (N = 103) . | Influenza B (N = 40) . | 2009 H1N1 (N = 18) . | ||
| Age, y, median (IQR) | 42 (32-54) | 41.5 (24-51) | 41.5 (18-52) | 42 (30-52) |
| Time after transplant, d, median (IQR) | 78 (40-197) | 69 (41-212) | 601.5 (270-977) | 80 (44-294) |
| Male sex | 62 (60.2) | 21 (52.5) | 8 (44.4) | 91 (56.5) |
| Disease risk at transplantation | ||||
| Nonadvanced | 59 (57.3) | 19 (47.5) | 9 (50.0) | 87 (54.0) |
| Advanced | 44 (42.7) | 21 (52.5) | 9 (50.0) | 74 (46.0) |
| Transplant type | ||||
| Autologous | 15 (14.6) | 11 (27.5) | 5 (27.8) | 31 (19.3) |
| Matched related | 39 (37.9) | 16 (40.0) | 4 (22.2) | 59 (36.6) |
| Mismatched or unrelated | 49 (47.6) | 13 (32.5) | 9 (50.0) | 71 (44.1) |
| Stem cell source | ||||
| Bone marrow or UBC | 45 (43.7%) | 20 (50.0%) | 5 (27.8%) | 70 (43.5%) |
| Peripheral blood | 58 (56.3%) | 20 (50.0%) | 13 (72.2%) | 91 (56.5%) |
| Conditioning regimen | ||||
| Myeloablative | 84 (81.4%) | 34 (85.0%) | 15 (83.3%) | 133 (82.6%) |
| Reduced intensity | 19 (18.5%) | 6 (15.0%) | 3 (16.7%) | 28 (17.4%) |
| Lymphocyte count (cells/mm3)* | ||||
| < 100 | 20 (20.0) | 18 (45.0) | 5 (29.4) | 43 (27.4) |
| 100-300 | 35 (35.0) | 6 (15.0) | 3 (17.6) | 44 (20.0) |
| > 300 | 45 (45.0) | 16 (40.0) | 9 (52.9) | 70 (44.6) |
| Corticosteroid treatment† | ||||
| None | 43 (41.7) | 20 (50.0) | 7 (38.9) | 70 (43.5) |
| Low-dose | 27 (26.2) | 16 (40.0) | 10 (55.6) | 53 (32.9) |
| High-dose | 33 (32.0) | 4 (10.0) | 1 (15.0) | 38 (23.6) |
| Early antiviral therapy for URD | ||||
| Yes (≤ 48 h)‡ | 39 (38.2) | 6 (15.0) | 7 (38.9) | 52 (32.5) |
| No (> 48 h)‡ | 11 (10.8) | 2 (5.0) | 6 (33.3) | 19 (11.9) |
| No antiviral therapy for URD§ | 52 (51.0) | 32 (80.0)‖ | 5 (27.8) | 89 (55.6) |
| Characteristics . | Virus type . | All patients (N = 161) . | ||
|---|---|---|---|---|
| Influenza A (N = 103) . | Influenza B (N = 40) . | 2009 H1N1 (N = 18) . | ||
| Age, y, median (IQR) | 42 (32-54) | 41.5 (24-51) | 41.5 (18-52) | 42 (30-52) |
| Time after transplant, d, median (IQR) | 78 (40-197) | 69 (41-212) | 601.5 (270-977) | 80 (44-294) |
| Male sex | 62 (60.2) | 21 (52.5) | 8 (44.4) | 91 (56.5) |
| Disease risk at transplantation | ||||
| Nonadvanced | 59 (57.3) | 19 (47.5) | 9 (50.0) | 87 (54.0) |
| Advanced | 44 (42.7) | 21 (52.5) | 9 (50.0) | 74 (46.0) |
| Transplant type | ||||
| Autologous | 15 (14.6) | 11 (27.5) | 5 (27.8) | 31 (19.3) |
| Matched related | 39 (37.9) | 16 (40.0) | 4 (22.2) | 59 (36.6) |
| Mismatched or unrelated | 49 (47.6) | 13 (32.5) | 9 (50.0) | 71 (44.1) |
| Stem cell source | ||||
| Bone marrow or UBC | 45 (43.7%) | 20 (50.0%) | 5 (27.8%) | 70 (43.5%) |
| Peripheral blood | 58 (56.3%) | 20 (50.0%) | 13 (72.2%) | 91 (56.5%) |
| Conditioning regimen | ||||
| Myeloablative | 84 (81.4%) | 34 (85.0%) | 15 (83.3%) | 133 (82.6%) |
| Reduced intensity | 19 (18.5%) | 6 (15.0%) | 3 (16.7%) | 28 (17.4%) |
| Lymphocyte count (cells/mm3)* | ||||
| < 100 | 20 (20.0) | 18 (45.0) | 5 (29.4) | 43 (27.4) |
| 100-300 | 35 (35.0) | 6 (15.0) | 3 (17.6) | 44 (20.0) |
| > 300 | 45 (45.0) | 16 (40.0) | 9 (52.9) | 70 (44.6) |
| Corticosteroid treatment† | ||||
| None | 43 (41.7) | 20 (50.0) | 7 (38.9) | 70 (43.5) |
| Low-dose | 27 (26.2) | 16 (40.0) | 10 (55.6) | 53 (32.9) |
| High-dose | 33 (32.0) | 4 (10.0) | 1 (15.0) | 38 (23.6) |
| Early antiviral therapy for URD | ||||
| Yes (≤ 48 h)‡ | 39 (38.2) | 6 (15.0) | 7 (38.9) | 52 (32.5) |
| No (> 48 h)‡ | 11 (10.8) | 2 (5.0) | 6 (33.3) | 19 (11.9) |
| No antiviral therapy for URD§ | 52 (51.0) | 32 (80.0)‖ | 5 (27.8) | 89 (55.6) |
Data are no. (%) of patients, unless otherwise indicated. Influenza A and B indicate seasonal influenza in all the tables and figures. One patient had H1N1 several years after experiencing an infection; with seasonal influenza A, only the first episode was included in the analyses.
IQR indicates interquartile range; MDS, myelodysplastic syndrome; and UBC, umbilical cord blood.
Lymphocyte counts were not available in 4 patients.
Low-dose indicates < 1 mg/kg of prednisone or oral beclomethasone diproprionate; and High-dose, ≥ 1 mg/kg of prednisone or prednisone equivalent dose of other steroids.
Time between influenza URD diagnosis and initiation of antiviral treatment.
This includes patients who receive no antiviral treatment ever after influenza diagnosis and who had LRD at the presentation.
Eighteen of 32 were diagnosed as influenza B infection before the regulatory approval of the neuraminidase inhibitors.