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Updated: Jul 9, 2025
Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant
Published on: May 27, 2011
Clinical Outcomes of Human Rhinovirus/Enterovirus Infection in Pediatric Hemopoietic Cell Transplant Patients
Sandra Castejon-Ramirez1,2, Sujittra Chaisavaneeyakorn1, Jose A Ferrolino1
1Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Insights
Human rhinovirus (HRV) infections are common in pediatric hemopoietic cell transplant (HCT) patients but do not increase respiratory illness severity or mortality. These findings suggest HCT may not need to be delayed for HRV diagnosis, even pre-transplant.
Area of Science:
- Pediatric Hematology/Oncology
- Infectious Diseases
- Transplant Medicine
Background:
- Respiratory viral infections are frequent in pediatric transplant recipients.
- Human rhinovirus (HRV) is the most common viral pathogen identified.
- HRV infection in hemopoietic cell transplant (HCT) patients is linked to lower respiratory tract infections (LRTI) and poor outcomes.
Purpose of the Study:
- To describe the clinical presentation and outcomes of HRV infection in pediatric HCT recipients.
- To evaluate the association between HRV infection and adverse respiratory outcomes post-HCT.
Main Methods:
- A single-center retrospective study included HCT recipients tested for HRV/enterovirus (HRV+) or negative for respiratory viruses (VN).
- Data were collected between October 2014 and December 2017.
- Primary outcomes included progression to LRTI, ICU admission, and mortality at 3 and 6 months.
Main Results:
- 47.6% of HCT recipients were HRV+; 88% were symptomatic, with diagnosis often occurring pre-transplant.
- HRV+ patients were younger and more frequently presented with cough and rhinorrhea.
- No significant differences were observed in LRTI progression, ICU admission, mechanical ventilation, or mortality between HRV+ and VN groups.
Conclusions:
- HRV infection is common in HCT recipients but not associated with increased respiratory disease severity, ICU admission, or mortality.
- Pre-transplant HRV diagnosis does not appear to necessitate delaying HCT.
- Larger, multicenter studies are needed to validate these findings.
Background:
Respiratory viral infections are common among pediatric transplant patients, with human rhinovirus (HRV) being the most frequent. In pediatric patients undergoing hemopoietic cell transplant (HCT), infection with HRV has been associated with progression to lower respiratory tract infection (LRTI) and adverse outcomes. We describe the clinical presentation and outcomes of HRV infection in children undergoing HCT.
Methods:
Single-center retrospective study. HCT recipients who were positive for HRV/EV (HRV+) or negative for any respiratory virus (VN) by BioFire® FilmArray® panel between October 2014 and December 2017, were included. Primary outcomes were progression to LRTI, ICU admission, all-cause mortality at 3 and 6 months, and respiratory event-related mortality at 6 months.
Results:
227 patients (160 allogeneic HCT) were included. Of all patients, 108/227 (47.6%) were HRV+. From all HRV+, 95/108 (88%) were symptomatic and 68/107 (63.6%) of the diagnosis were made pretransplant. The median age of HRV+ was significantly lower than VN patients (5 vs 10 years). Cough and rhinorrhea were more frequently observed in HRV+ (53.7 and 60% vs 19.8 and 22.8%, respectively). No differences were found between both groups pretransplant and overall in rates progression to LRTI, ICU admission, mechanical ventilation, all-cause within 3 and 6 months, and mortality related with respiratory failure. No significant association was found between the severity of respiratory disease and the type of conditioning, type of transplant, or absolute lymphocyte count.
Conclusions:
HRV infection is frequently detected in HCT recipients but is not associated with severity of respiratory disease, need for intensive care unit or mortality, including those diagnosed before transplant, suggesting that delaying HCT in this scenario may not be needed. Multicenter larger studies are required to confirm these findings.
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