Increasing incidence of adenovirus disease in bone marrow transplant recipients

Area of Science:

• Infectious Diseases
• Hematology
• Transplantation Immunology

Background:

• Bone marrow transplantation (BMT) recipients are immunocompromised, increasing susceptibility to opportunistic infections.
• Adenovirus infections post-BMT can lead to significant morbidity and mortality.
• Previous studies suggest a lower incidence of adenovirus infections and disease in BMT patients.

Purpose of the Study:

• To retrospectively review adenovirus infections in bone marrow transplant recipients.
• To determine the incidence, timing, and risk factors of adenovirus infection and disease post-BMT.
• To compare adenovirus infection rates between pediatric and adult BMT recipients.

Main Methods:

• Retrospective review of 201 bone marrow transplant recipients over a 4-year period.
• Analysis of adenovirus cultures obtained post-BMT.
• Correlation of adenovirus infection with patient demographics, transplant characteristics, and clinical outcomes.

Main Results:

• Adenovirus was detected in 20.9% of BMT recipients.
• Pediatric patients had a higher incidence (31.3%) and earlier onset (<30 days) of adenovirus infection compared to adults (13.6%, >90 days).
• Adenovirus type 35 was the most common serotype; one-third of infected patients developed adenovirus disease, with graft-versus-host disease and multi-site viral isolation as risk factors.

Conclusions:

• Adenovirus infections and disease occur more frequently in BMT recipients than previously reported.
• Pediatric BMT recipients are at higher risk for earlier and more frequent adenovirus infections.
• Adenovirus may become a more significant pathogen with the increasing prevalence of high-risk BMT procedures.