Viral kinetics and outcomes of adenovirus viremia following allogeneic hematopoietic cell transplantation

Aditya Chandorkar, Anthony D. Anderson, Michele I Morris, Yoichiro Natori, Antonio Jimenez, Krishna V. Komanduri, Jose F. Camargo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Adenovirus (AdV) is a serious infection following hematopoietic cell transplantation (HCT). Little is known about AdV viral kinetics and optimal threshold for initiation of pre-emptive therapy. Methods: Single-center retrospective study of 16 consecutive adult HCT recipients with detectable AdV identified over a 5-year period. Results: Median time to AdV reactivation after HCT was 176 days (IQR 86–408). Nine patients received cidofovir, although 14/16 had no tissue-invasive disease. Among treated patients, median duration of viremia was shorter when initiating treatment at viral loads < 10,000 copies/ml (28 vs. 52 days). All-cause mortality in this cohort was 44%. All six patients (five of which were untreated) with peak viral loads < 10,000 copies/ml survived; whereas only 30% (3/10) of patients with peak viral loads greater than this threshold survived, despite most (n = 8; 80%) of them receiving cidofovir (P =.01). Three-month survival following diagnosis of AdV viremia was significantly lower with peak viremia > 10,000 copies/ml (100 vs. 17%; P =.005). Conclusion: AdV is associated with high all-cause mortality, especially for viremia > 10,000 copies/ml. Delaying therapy until viremia reaches AdV levels ≥10,000 copies/ml was associated with more protracted infection and poor outcomes. Larger studies are needed.

Original languageEnglish (US)
JournalClinical Transplantation
DOIs
StateAccepted/In press - 2021

Keywords

  • adenovirus
  • allogeneic hematopoietic cell transplants
  • cidofovir
  • outcomes

ASJC Scopus subject areas

  • Transplantation

Fingerprint

Dive into the research topics of 'Viral kinetics and outcomes of adenovirus viremia following allogeneic hematopoietic cell transplantation'. Together they form a unique fingerprint.

Cite this