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Influence of respiratory viruses on airflow decline after allogenic hematopoietic stem cell transplantation

Camille de Seynes, Hervé Fleury, Noël Milpied, Reza Tabrizi, Stéphane Vigouroux, Claire Dromer, Chantal Raherison, Elodie Blanchard
European Respiratory Journal 2016 48: PA2599; DOI: 10.1183/13993003.congress-2016.PA2599
Camille de Seynes
1Pneumologie, CHU de Bordeaux, Bordeaux, France
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Hervé Fleury
2Virologie, CHU de Bordeaux, Bordeaux, France
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Noël Milpied
3Hématologie, CHU de Bordeaux, Bordeaux, France
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Reza Tabrizi
3Hématologie, CHU de Bordeaux, Bordeaux, France
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Stéphane Vigouroux
3Hématologie, CHU de Bordeaux, Bordeaux, France
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Claire Dromer
1Pneumologie, CHU de Bordeaux, Bordeaux, France
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Chantal Raherison
1Pneumologie, CHU de Bordeaux, Bordeaux, France
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Elodie Blanchard
1Pneumologie, CHU de Bordeaux, Bordeaux, France
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Abstract

Introduction: Community acquired respiratory virus (CARV) commonly infects patients following hematopoietic stem cell transplantation (HSCT), causing acute infection but also long-term decline in lung function, as a trigger to alloimmune lung syndrome. We conducted a 3-year case-control study to determine the effect of CARV detected by multiplex PCR on airflow decline.

Methods: The PFT (Pulmonary functional test) of symptomatic adult HSCT recipients who had a positive PCR for CARV between September 2012 and May 2015 were compared to PFT of those with negative PCR. The viruses detected were Influenza, Respiratory Syncytial Virus, Metapneumovirus, Coronavirus, Rhinovirus, Enterovirus, Parainfluenza, Adenovirus and Bocavirus.

Results: During the study period, 112 cases and 39 controls were considered. Cases underwent 179 infectious episodes confirmed by PCR, 40,7% were complicated by lower respiratory tract infection and 47,5% developed GVHD (Graft versus Host disease) post infection. Of 78 cases with positive PCR and complete PFTs, 42% developed persistent FEV-1 decline >5% more than 6 weeks after the episode, versus 18% in the control group (OR 3,35; CI 95% [0,063-0,42]; p = 0,009) and 23% developed persistent FEV-1 decline >10%, versus 7,7% in the control group (OR 3,60; CI 95% [0,062-0,030]; p = 0,041).

Conclusion: CARV infection were associated with long term airflow decline in adult HSCT recipients. The role of associated factors like type of virus, stem cell source, smoking status, lymphopenia, hypogammaglobulinemia, treatment by corticosteroids or other immunosuppressive drug, former GVHD or multiple infections will be evaluated in a multivariate analysis.

  • Infections
  • Immunosuppression
  • Bronchiolitis
  • Copyright ©the authors 2016
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Influence of respiratory viruses on airflow decline after allogenic hematopoietic stem cell transplantation
Camille de Seynes, Hervé Fleury, Noël Milpied, Reza Tabrizi, Stéphane Vigouroux, Claire Dromer, Chantal Raherison, Elodie Blanchard
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2599; DOI: 10.1183/13993003.congress-2016.PA2599

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Influence of respiratory viruses on airflow decline after allogenic hematopoietic stem cell transplantation
Camille de Seynes, Hervé Fleury, Noël Milpied, Reza Tabrizi, Stéphane Vigouroux, Claire Dromer, Chantal Raherison, Elodie Blanchard
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2599; DOI: 10.1183/13993003.congress-2016.PA2599
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