Adenovirus infections in adult recipients of blood and marrow transplants

Alberto M. La Rosa, Richard E. Champlin, Nadeem Mirza, James Gajewski, Sergio Giralt, Kenneth V. Rolston, Isaam Raad, Kalen Jacobson, Dimitrios Kontoyiannis, Linda Elting, Estella Whimbey

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    Abstract

    Adenoviruses are increasingly recognized pathogens that affect blood and marrow transplant (BMT) recipients. Experiences with 2889 adult BMT recipients were reviewed to study the incidence, clinical spectrum, risk factors for dissemination, response to therapy, and outcome of adenovirus infections. Eight-five patients (3%) were diagnosed by means of culture (n = 85) or culture and histopathological examination (n = 6). Nine patients had asymptomatic viruria, and 76 had symptomatic infections, which included upper respiratory tract infection (n = 20), enteritis (n = 18), hemorrhagic cystitis (n = 10), pneumonia (n = 15), and disseminated disease (n = 13). The overall mortality rate was 26%. A higher mortality rate was observed among patients with pneumonia (73%) and disseminated disease (61%). Risk factors for dissemination included receipt of an allogeneic transplant, presence of graft-versus-host disease (GVHD), and receipt of concurrent immunosuppressive therapy. Intravenous ribavirin was not associated with an appreciable benefit among 12 patients who received this treatment. In conclusion, adenovirus infections are an important cause of morbidity and mortality in adult BMT recipients, particularly allogeneic transplant recipients with GVHD who are receiving immunosuppressive therapy. The need for an effective, nontoxic antiviral therapy is apparent.

    Original languageEnglish (US)
    Pages (from-to)871-876
    Number of pages6
    JournalClinical Infectious Diseases
    Volume32
    Issue number6
    DOIs
    StatePublished - Mar 15 2001

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    ASJC Scopus subject areas

    • Microbiology (medical)
    • Infectious Diseases

    Cite this

    La Rosa, A. M., Champlin, R. E., Mirza, N., Gajewski, J., Giralt, S., Rolston, K. V., Raad, I., Jacobson, K., Kontoyiannis, D., Elting, L., & Whimbey, E. (2001). Adenovirus infections in adult recipients of blood and marrow transplants. Clinical Infectious Diseases, 32(6), 871-876. https://doi.org/10.1086/319352