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Bone Marrow Transplant. 2018 Dec 13. doi: 10.1038/s41409-018-0421-0. [Epub ahead of print]

A survey on incidence and management of adenovirus infection after allogeneic HSCT.

Author information

1
Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy. simone.cesaro@aovr.veneto.it.
2
Pediatric Onco-Hematology, City of Health and Science, Regina Margherita Children Hospital, Turin, Italy.
3
Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
4
Division of Infectious Diseases, University of Genova (DISSAL) and IRCCS Ospedale Policlinico San Martino, Genova, Italy.
5
Division of Infection and Immunity, University College London, London, UK.
6
Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
7
Infectious Disease Working Party Data Office, University of Leiden, Leiden, The Netherlands.
8
Pediatric Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
9
Department of Pediatric Hematology and Oncology, University Hospital, Collegium Medicum UMK, Bydgoszcz, Poland.

Abstract

To determine the current practices on the management of Adenovirus (ADV) infection after allogenic stem cell transplantation, a survey was undertook among EBMT centres. The response rate was 20% (91/446): 46% were adult, 44% were paediatric and 10% were mixed centres, respectively. The overall incidence of ADV infection was 7.1%: 4.1% in adult, 15.4% in paediatric, and 3.6% in mixed population. The determination of ADV-DNA in biological samples was used in 96% of centres; 58% of them monitored asymptomatic patients with a frequency of twice a week in 9%, once a week in 45%, every two weeks in 4% of centres. The treatment of ADV infection was mainly based on the administration of cidofovir (87%), being the schedule of 5 mg/kg/week with probenecid the most used, and the reduction of immunosuppression (84%). The threshold of ADV-DNAemia to start cidofovir in high-risk patients was most frequently >1000 copies/ml. Innovative treatments, such as brincidofovir and adoptive ADV-cytotoxic-T-lymphocytes, were used in 27% and 20% of centres, respectively. Almost all responding centres consider ADV infection serious enough to deserve testing asymptomatic or symptomatic patients. Cidofovir and reduction of immunosuppression represent the main therapeutic options but one fourth of responding centres experimented novel therapies.

PMID:
30546071
DOI:
10.1038/s41409-018-0421-0

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