Characteristics of adenovirus-positive patients
Patient . | Age, y . | Diagnosis . | Donor . | Source . | T-cell depletion . | aGvHD during AdV infection/grade* . | AdV species . | Site of detection . | Day of CMV detection in PB before/after BMT† . | Day of AdV detection before/after BMT‡ . | AdV disease . | Outcome . | Day of death after BMT . | Cause of death . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 9 | WG | MSD | BM | No | No | D | Stool | +56 | +7 | No | A/W | ||
| 2 | 3 | AML | MUD | PBSC | 1+2 | No | C | Stool | -13 | 0 | No | A/W | ||
| 3 | 20 | ALL | MUD | BM | 1 | No | F | Stool, organ biopsy (postmortem) | ND | +59 | No | Died | +101 | CMV |
| 4 | 1 | HLH | MMFD | PBSC | 1+2 | NE | F | Stool, throat | -10 | -7 | Enteritis | Died | +2 | HLH |
| 5 | 8 | ALL | MMFD | PBSC | 1+2 | No | C | Stool | +1 | >+100 | Enteritis | A/W | ||
| 6 | 3 | ALL | MUD | PBSC | 1+2 | No | A | Stool | +17 | >+100 | Enteritis | Died | +131 | Toxicity |
| 7 | 8 | ALL | MUD | BM | 1 | No§ | C | Stool | +12 | +90 | No | A/W | ||
| 8 | 3 | FHL | MUD | PBSC | 1+2 | No | C+B | Stool, throat (C)/stool (B) | -5 | -7(C)/>+100 (B) | No | Died | +153 | Aspergillus |
| 9 | 5 | FA | MMFD | PBSC | 1+2 | No | C | Stool | ND | +49 | Enteritis | Died | +70 | Toxicity |
| 10 | 2 | FHL | MMFD | PBSC | 1+2 | No | C | Throat | ND | > +100 | No | A/W | ||
| 11 | 10 | ALL | MMFD | PBSC | 1+2 | No | C | Stool | ND | +91 | No | Died | +120 | Legionella |
| 12 | 10 | CML | MSD | BM | No | No | C | Skin | ND | > +100 | Rash | A/W | ||
| 13 | 7 | SAA | MFD | PBSC | 1+2 | No | C | Throat | ND | > +100 | No | A/W | ||
| 14 | 3 | AML | MUD | PBSC | 1 | No | C | Organ biopsy (postmortem) | ND | +39 | No | Died | +39 | Toxicity |
| 15 | 16 | SAA | MMFD | PBSC | 1+2 | NE | C | Throat | ND | +10 | No | Died | +74 | Aspergillus |
| 16 | 4 | XLP | MUD | PBSC | 1+2 | No | C | Stool | ND | +8 | No | A/W | ||
| 17 | 11 | AML | MSD | BM | No | No | D | Stool | +52 | +10 | No | A/W | ||
| 18∥ | 1 | MPS 1 | MUD | PBSC | 1+2 | Yes/3 | C | Stool | +6 | +53 | Enteritis | A/W | ||
| 19∥ | 1 | MPS 1 | MUD | PBSC | 1+2 | Yes/3 | C | Stool | ND | +23 | Enteritis | A/W | ||
| 20 | 7 | MDS | MSD | BM | No | No | C | Stool | -12 | -7 | No | A/W | ||
| 21 | 0 | SCID | MMFD | PBSC | 1+2 | No | C | Stool | ND | +18 | Enteritis | Died | +170 | SID |
| 22 | 9 | ALL | MUD | PBSC | 1 | No | C | Stool | ND | -7 | No | A/W | ||
| 23 | 1 | HLH | MUD | PBSC | 1+2 | No | C | Stool | ND | -7 | No | A/W | ||
| 24 | 8 | AML | MUD | BM | 1 | No | D+F | Stool | ND | -7(D)/+19(F) | No | A/W | ||
| 25 | 1 | CGD | MUD | BM | 1 | No | C | Stool | ND | -7 | No | A/W | ||
| 26∥ | 5 | ALL | MMFD | PBSC | 1+2 | No | C | PB | +4 | +16 | Disseminated | Died | +69 | AdV |
| 27 | 0 | JMML | MUD | BM | 1 | No | C | PB, stool, throat | -11 | +18[+20] | No | Died | +424 | CMV |
| 28 | 5 | ALL | MMFD | PBSC | 1+2 | No§ | C | PB, stool, organ biopsy (postmortem) | > +100 [+139] | > +100 [+150] | Disseminated | Died | +198 | AdV |
| 29 | 3 | AML | MMFD | PBSC | 1+2 | No | C | PB, stool, urine | +41 | -7[+13] | No | Died | +302 | Relapse |
| 30 | 9 | FA | MUD | PBSC | 1+2 | No | C | PB, stool, urine, throat | +38 | +72 | Disseminated | Died | +79 | AdV |
| 31∥ | 9 | CML | MUD | PBSC | 1+2 | No | C | PB, organ biopsy (postmortem) | -43 | -7 | Disseminated | Died | +8 | AdV |
| 32 | 2 | JMML | MUD | BM | 1 | Yes/2 | C | PB | ND | +13 | No | A/W | ||
| 33 | 12 | AML | MUD | PBSC | 1 | No | C | PB, stool, throat, urine, organ biopsy (postmortem) | +14 | +36 | Disseminated | Died | +64 | AdV |
| 34 | 3 | AML | MUD | PBSC | 1+2 | No | A | PB, throat, liver | -10 | -7 | Disseminated | Died | +24 | AdV |
| 35 | 8 | ALL | MMFD | PBSC | 1+2 | No | A+B | PB, stool, throat, urine, CSF (A)/stool(B) | ND | +11(A)/-7(B) | Disseminated | Died | +31 | AdV |
| 36∥ | 2 | MPS 1 | MUD | PBSC | 1+2 | Yes/4 | B+C | PB, stool, throat, urine, CSF, eye (C)/stool(B) | ND | -7(C)[+26]/ > +100(B) | Disseminated | Died | +151 | AdV |
Patient . | Age, y . | Diagnosis . | Donor . | Source . | T-cell depletion . | aGvHD during AdV infection/grade* . | AdV species . | Site of detection . | Day of CMV detection in PB before/after BMT† . | Day of AdV detection before/after BMT‡ . | AdV disease . | Outcome . | Day of death after BMT . | Cause of death . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 9 | WG | MSD | BM | No | No | D | Stool | +56 | +7 | No | A/W | ||
| 2 | 3 | AML | MUD | PBSC | 1+2 | No | C | Stool | -13 | 0 | No | A/W | ||
| 3 | 20 | ALL | MUD | BM | 1 | No | F | Stool, organ biopsy (postmortem) | ND | +59 | No | Died | +101 | CMV |
| 4 | 1 | HLH | MMFD | PBSC | 1+2 | NE | F | Stool, throat | -10 | -7 | Enteritis | Died | +2 | HLH |
| 5 | 8 | ALL | MMFD | PBSC | 1+2 | No | C | Stool | +1 | >+100 | Enteritis | A/W | ||
| 6 | 3 | ALL | MUD | PBSC | 1+2 | No | A | Stool | +17 | >+100 | Enteritis | Died | +131 | Toxicity |
| 7 | 8 | ALL | MUD | BM | 1 | No§ | C | Stool | +12 | +90 | No | A/W | ||
| 8 | 3 | FHL | MUD | PBSC | 1+2 | No | C+B | Stool, throat (C)/stool (B) | -5 | -7(C)/>+100 (B) | No | Died | +153 | Aspergillus |
| 9 | 5 | FA | MMFD | PBSC | 1+2 | No | C | Stool | ND | +49 | Enteritis | Died | +70 | Toxicity |
| 10 | 2 | FHL | MMFD | PBSC | 1+2 | No | C | Throat | ND | > +100 | No | A/W | ||
| 11 | 10 | ALL | MMFD | PBSC | 1+2 | No | C | Stool | ND | +91 | No | Died | +120 | Legionella |
| 12 | 10 | CML | MSD | BM | No | No | C | Skin | ND | > +100 | Rash | A/W | ||
| 13 | 7 | SAA | MFD | PBSC | 1+2 | No | C | Throat | ND | > +100 | No | A/W | ||
| 14 | 3 | AML | MUD | PBSC | 1 | No | C | Organ biopsy (postmortem) | ND | +39 | No | Died | +39 | Toxicity |
| 15 | 16 | SAA | MMFD | PBSC | 1+2 | NE | C | Throat | ND | +10 | No | Died | +74 | Aspergillus |
| 16 | 4 | XLP | MUD | PBSC | 1+2 | No | C | Stool | ND | +8 | No | A/W | ||
| 17 | 11 | AML | MSD | BM | No | No | D | Stool | +52 | +10 | No | A/W | ||
| 18∥ | 1 | MPS 1 | MUD | PBSC | 1+2 | Yes/3 | C | Stool | +6 | +53 | Enteritis | A/W | ||
| 19∥ | 1 | MPS 1 | MUD | PBSC | 1+2 | Yes/3 | C | Stool | ND | +23 | Enteritis | A/W | ||
| 20 | 7 | MDS | MSD | BM | No | No | C | Stool | -12 | -7 | No | A/W | ||
| 21 | 0 | SCID | MMFD | PBSC | 1+2 | No | C | Stool | ND | +18 | Enteritis | Died | +170 | SID |
| 22 | 9 | ALL | MUD | PBSC | 1 | No | C | Stool | ND | -7 | No | A/W | ||
| 23 | 1 | HLH | MUD | PBSC | 1+2 | No | C | Stool | ND | -7 | No | A/W | ||
| 24 | 8 | AML | MUD | BM | 1 | No | D+F | Stool | ND | -7(D)/+19(F) | No | A/W | ||
| 25 | 1 | CGD | MUD | BM | 1 | No | C | Stool | ND | -7 | No | A/W | ||
| 26∥ | 5 | ALL | MMFD | PBSC | 1+2 | No | C | PB | +4 | +16 | Disseminated | Died | +69 | AdV |
| 27 | 0 | JMML | MUD | BM | 1 | No | C | PB, stool, throat | -11 | +18[+20] | No | Died | +424 | CMV |
| 28 | 5 | ALL | MMFD | PBSC | 1+2 | No§ | C | PB, stool, organ biopsy (postmortem) | > +100 [+139] | > +100 [+150] | Disseminated | Died | +198 | AdV |
| 29 | 3 | AML | MMFD | PBSC | 1+2 | No | C | PB, stool, urine | +41 | -7[+13] | No | Died | +302 | Relapse |
| 30 | 9 | FA | MUD | PBSC | 1+2 | No | C | PB, stool, urine, throat | +38 | +72 | Disseminated | Died | +79 | AdV |
| 31∥ | 9 | CML | MUD | PBSC | 1+2 | No | C | PB, organ biopsy (postmortem) | -43 | -7 | Disseminated | Died | +8 | AdV |
| 32 | 2 | JMML | MUD | BM | 1 | Yes/2 | C | PB | ND | +13 | No | A/W | ||
| 33 | 12 | AML | MUD | PBSC | 1 | No | C | PB, stool, throat, urine, organ biopsy (postmortem) | +14 | +36 | Disseminated | Died | +64 | AdV |
| 34 | 3 | AML | MUD | PBSC | 1+2 | No | A | PB, throat, liver | -10 | -7 | Disseminated | Died | +24 | AdV |
| 35 | 8 | ALL | MMFD | PBSC | 1+2 | No | A+B | PB, stool, throat, urine, CSF (A)/stool(B) | ND | +11(A)/-7(B) | Disseminated | Died | +31 | AdV |
| 36∥ | 2 | MPS 1 | MUD | PBSC | 1+2 | Yes/4 | B+C | PB, stool, throat, urine, CSF, eye (C)/stool(B) | ND | -7(C)[+26]/ > +100(B) | Disseminated | Died | +151 | AdV |
Patients 1 to 25 are those who tested RQ-PCR positive at 1 or 2 sites other than peripheral blood. Patients 26 to 36 are those who tested RQ-PCR positive at sites including peripheral blood. AdV indicates adenovirus; CMV, cytomegalovirus; BMT, bone marrow transplantation; WG, Wegener granulomatosis; MSD, matched sibling donor; BM, bone marrow; A/W, alive and well; AML, acute myeloid leukemia; MUD, marrow unrelated donor; PBCS, peripheral stem cell transplantation; T-cell depletion 1, antithymocyte globulin (ATG); T-cell depletion 2, CD34+ positive selection; ALL, acute lymphoblastic leukemia; ND, not detected; HLH, hemophagocytic lymphohistiocytosis; MMFD, mismatched family donor; NE, not evaluable; FHL, familial hemophagocytic lymphohistiocytosis; FA, Fanconi anemia; CML, chronic myeloid leukemia; SAA, severe aplastic anemia; XLP, X-linked lymphoproliferative disease; MPS 1, mucopolysaccharidosis type 1; SCID, severe combined immunodeficiency; SID, sudden infant death; CGD, chronic granulomatous disease; JMML, juvenile myelomonocytic leukemia; CSF, cerebrospinal fluid
The highest grade of acute graft-versus-host disease (aGvHD) observed during the time of AdV infection is indicated. (For overall incidence of aGvHD during the posttransplantation period, see Table 1)
Patient 31 is indicated as CMV positive on day -43. The availability of CMV data at this unusual time point is attributable to the fact that the patient had undergone his first SCT more than 3 months earlier. In patients who had both AdV and CMV detectable in PB (26-31, 33, 34), the median time point of first PCR positivity was day +9 (range, -43 to +139) for CMV and +14.5 (range, -7 to +150) for AdV. In one instance (patient 31), AdV detection in PB preceded that of CMV by 28 days, but in the remaining cases detection of CMV preceded first AdV positivity in PB by 3 to 36 days (median, 17). None of the patients who tested CMV positive prior to transplantation had evidence of active infection, as revealed by RQ-PCR monitoring
The letters in parentheses indicate the AdV species. The appearance of AdV in PB is indicated in brackets if the virus was first detected at a site other than PB. Two patients (31 and 34) had AdV detectable in PB at the commencement of conditioning, but the transplantation could not be postponed because of the presence of leukemia in progression. In all other patients with AdV infection prior to transplantation, the virus was detectable in stool only
These patients had chronic GvHD during the course of AdV infection. In both instances, the GvHD was graded as extensive
Patients who had undergone a prior SC transplantation