1. Burden of adenoviraemia predicts survival in paediatric recipients of allogeneic haematopoietic stem cell transplant.
- Author
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Deambrosis D, Davies E, Turner A, Guiver M, Bonney D, Campbell H, Wynn RF, and Hiwarkar P
- Subjects
- Adolescent, Child, Child, Preschool, Hematopoietic Stem Cell Transplantation adverse effects, Humans, Infant, Predictive Value of Tests, Retrospective Studies, Transplant Recipients statistics & numerical data, Transplantation Conditioning adverse effects, Transplantation, Homologous mortality, Viral Load statistics & numerical data, Adenoviridae Infections blood, Hematopoietic Stem Cell Transplantation mortality, Transplantation Conditioning mortality, Viremia etiology
- Abstract
Background: Adenoviraemia occurs in 15 to 30% of paediatric allogeneic haematopoietic stem cell transplant (HSCT) recipients, and is a significant cause of morbidity and mortality which lacks satisfactory therapeutic options. The relationship between burden of adenovirus and mortality is poorly defined in this patient group., Objectives: To determine the relationship between adenoviraemia and mortality in paediatric HSCT recipients., Study Design: A retrospective review of blood adenovirus PCR results in paediatric HSCT recipients spanning February 2003 to September 2016 was conducted. Three measures of adenovirus burden were defined; number of days with significant viraemia, peak adenovirus load and Area under the Curve and related to outcome post-HSCT., Results: A total of 62 patients with episodes of positive blood adenovirus PCR were identified for analysis. Adenoviraemia of more than 7 days, peak viral load of >8000 copies/ml and higher 16 week Area under the Curve were all significantly associated with higher non-relapse mortality in paediatric HSCT recipients., Conclusions: This retrospective analysis highlights the important predictive value of adenoviral load for non-relapse mortality in young allogeneic HSCT recipients. These data also suggest a possible role for use of these measures as end points in trials of novel adenoviral therapies., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)
- Published
- 2020
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