Clinical Infectious Diseases Advance Access published March 5, 2014 1
Parainfluenza Virus Lower Respiratory Tract Disease after Hematopoietic Cell
cr ipt
Transplantation: Viral Detection in the Lung Predicts Outcome
3
Department of Pediatrics, University of Washington, Seattle, WA Pediatric Infectious Diseases Division, Seattle Children’s Hospital, Seattle, WA 5 Department of Laboratory Medicine, University of Washington, Seattle, WA 6 Department of Medicine, University of Washington, Seattle, WA
an
4
M
Corresponding author: Michael Boeckh, MD, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109, USA, TEL: +1-206-667-6706, FAX: +1-206-667-4411, E-mail: [email protected] *
pt ed
At time of submission, Dr. Campbell’s affiliation is: Centers for Disease Control and Prevention, Atlanta, GA Alternate corresponding author: Sachiko Seo, MD, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North,
Seattle, WA 98109, USA, TEL: +1-206-667-1423, FAX: +1-206-667-4411, E-mail: [email protected]
ce
Key points: We propose a new definition of lower respiratory tract disease based on
Ac
the viral detection site that correlates with clinical outcome. Monocyte count, oxygen use and high-dose steroid are associated with mortality after parainfluenza virus lower respiratory tract disease.
© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].
Downloaded from http://cid.oxfordjournals.org/ at Karolinska Institutet on June 17, 2014
us
Sachiko Seo1, Hu Xie2, Angela P. Campbell1,2,3,4,*, Jane M. Kuypers1,5, Wendy M. Leisenring2, Janet A. Englund3,4, and Michael Boeckh1,2,6 1 Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 2 Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
2
cr ipt
Abstract
Background. Parainfluenza virus (PIV) commonly infects patients following
hematopoietic cell transplantation (HCT), frequently causing lower respiratory tract disease (LRD). The definition of LRD significantly differs among studies evaluating
us an
Methods. We retrospectively evaluated 544 HCT recipients with laboratory-confirmed
M
PIV and classified LRD into three groups: possible (PIV detection in upper respiratory tract with new pulmonary infiltrates with/without LRD symptoms), probable (PIV
pt ed
detection in lung with LRD symptoms without new pulmonary infiltrates), and proven (PIV detection in lung with new pulmonary infiltrates with/without LRD symptoms).
Results. Probabilities of 90-day survival after LRD were 87%, 58% and 45% in
ce
possible, probable and proven cases, respectively. Patients with probable and proven
Ac
LRD had significantly worse survival than those with upper respiratory tract infection (probable; HR, 5.87; p
Parainfluenza Virus Lower Respiratory Tract Disease after Hematopoietic Cell
cr ipt
Transplantation: Viral Detection in the Lung Predicts Outcome
3
Department of Pediatrics, University of Washington, Seattle, WA Pediatric Infectious Diseases Division, Seattle Children’s Hospital, Seattle, WA 5 Department of Laboratory Medicine, University of Washington, Seattle, WA 6 Department of Medicine, University of Washington, Seattle, WA
an
4
M
Corresponding author: Michael Boeckh, MD, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109, USA, TEL: +1-206-667-6706, FAX: +1-206-667-4411, E-mail: [email protected] *
pt ed
At time of submission, Dr. Campbell’s affiliation is: Centers for Disease Control and Prevention, Atlanta, GA Alternate corresponding author: Sachiko Seo, MD, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North,
Seattle, WA 98109, USA, TEL: +1-206-667-1423, FAX: +1-206-667-4411, E-mail: [email protected]
ce
Key points: We propose a new definition of lower respiratory tract disease based on
Ac
the viral detection site that correlates with clinical outcome. Monocyte count, oxygen use and high-dose steroid are associated with mortality after parainfluenza virus lower respiratory tract disease.
© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].
Downloaded from http://cid.oxfordjournals.org/ at Karolinska Institutet on June 17, 2014
us
Sachiko Seo1, Hu Xie2, Angela P. Campbell1,2,3,4,*, Jane M. Kuypers1,5, Wendy M. Leisenring2, Janet A. Englund3,4, and Michael Boeckh1,2,6 1 Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 2 Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
2
cr ipt
Abstract
Background. Parainfluenza virus (PIV) commonly infects patients following
hematopoietic cell transplantation (HCT), frequently causing lower respiratory tract disease (LRD). The definition of LRD significantly differs among studies evaluating
us an
Methods. We retrospectively evaluated 544 HCT recipients with laboratory-confirmed
M
PIV and classified LRD into three groups: possible (PIV detection in upper respiratory tract with new pulmonary infiltrates with/without LRD symptoms), probable (PIV
pt ed
detection in lung with LRD symptoms without new pulmonary infiltrates), and proven (PIV detection in lung with new pulmonary infiltrates with/without LRD symptoms).
Results. Probabilities of 90-day survival after LRD were 87%, 58% and 45% in
ce
possible, probable and proven cases, respectively. Patients with probable and proven
Ac
LRD had significantly worse survival than those with upper respiratory tract infection (probable; HR, 5.87; p
