Challenges of Dengue in Hematological Disease Patients: Descriptive Analysis From the DANGO Registry During the 2023-2024 Outbreak in Argentina

Dengue virus (DENV) infection is an increasing public health concern in immunocompromised patients, including those with hematological disease (HD). Clinical overlap between DENV and HD-related complications often leads to underdiagnosis, and data on DENV outcomes in HD patients were limited during the 2023-2024 outbreak in Argentina.

We conducted a retrospective, multicenter analysis of HD patients with laboratory-confirmed or highly probable DENV infection reported to the Argentine DANGO registry between November 2023 and May 2024. Seven centers participated. Patients aged ≥16 years were included, and demographic, clinical, laboratory, treatment, and outcome data were analyzed descriptively.

Thirty-three HD patients with DENV were included. Median age was 54 years (IQR 33-63), and 70% were male. Non-Hodgkin lymphoma (30%) and acute myeloid leukemia (21%) were the most common HD. Most patients (82%) were receiving active chemotherapy, and 24% had undergone hematopoietic stem cell transplantation (HSCT). Hospitalization was required in 64% of cases. Thrombocytopenia occurred in 90%, leukopenia in 67%, and hematocrit <30% in 52%. DENV with warning signs was observed in 64% of patients. Two cases of transfusion-associated DENV were documented via PCR-positive platelet donor samples. Overall mortality was 6% (2/33), with both deaths directly attributable to DENV-related complications.

DENV infection in patients with HD is associated with frequent complications, high hospitalization rates, and substantial morbidity and non-negligible mortality. Symptom overlap with HD-related conditions complicates diagnosis. Increased clinical awareness, standardized diagnostic approaches, and strengthened transfusion safety measures are essential in endemic areas, especially during outbreaks.