The characteristics and outcomes of parainfluenza virus infections in 200 patients with leukemia or recipients of hematopoietic stem cell transplantation.

Abstract	Community respiratory viruses are significant causes of morbidity and mortality in patients with leukemia and hematopoietic stem cell transplant (HSCT) recipients. Data on characteristics and outcomes of parainfluenza virus (PIV) infections in these patients are limited. We reviewed the records of patients with leukemia and HSCT recipients who developed PIV infections to determine the characteristics and outcomes of such infections. We identified 200 patients with PIV infections, including 80 (40%) patients with leukemia and 120 (60%) recipients of HSCT. At presentation, most patients (70%) had an upper respiratory tract infection and the remaining patients (30%) had pneumonia. Neutropenia, APACHE II score more than 15, and respiratory coinfections were independent predictors of progression to pneumonia on multivariate analysis. Overall mortality rate was 9% at 30 days after diagnosis and 17% among patients who had PIV pneumonia, with no significant difference between patients with leukemia and HSCT recipients (16% vs 17%). On multivariate analysis, independent predictors of death were relapsed or refractory underlying malignancy, APACHE II score more than 15, and high-dose steroid use. Patients with leukemia and HSCT are at risk for serious PIV infections, including PIV pneumonia, with a significant mortality rate. We identified multiple risk factors for progression to pneumonia and death.
Authors	Roy F Chemaly, Santosh S Hanmod, Dhanesh B Rathod, Shashank S Ghantoji, Ying Jiang, Arpan Doshi, Karen Vigil, Javier A Adachi, Andrew M Khoury, Jeffery Tarrand, Chitra Hosing, Richard Champlin
Journal	Blood (Blood) Vol. 119 Issue 12 Pg. 2738-45; quiz 2969 (Mar 22 2012) ISSN: 1528-0020 [Electronic] United States
PMID	22246027 (Publication Type: Journal Article)
Chemical References	Antiviral Agents
Topics	Adolescent Adult Aged Aged, 80 and over Antiviral Agents (therapeutic use) Disease Progression Female Hematopoietic Stem Cell Transplantation Humans Kaplan-Meier Estimate Leukemia (complications, mortality) Male Middle Aged Paramyxoviridae Infections (complications, drug therapy, mortality) Risk Factors Young Adult

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