Minna Koskenvuo1,2, Jaana Rahiala1,3, Mohammadreza Sadeghi4, Matti Waris5,6, Tytti Vuorinen5,6, Maija Lappalainen7, Päivi Norja4, Mari Toppinen4, Ulla Saarinen-Pihkala1, Tobias Allander8, Maria Söderlund-Venermo4, Klaus Hedman4, Olli Ruuskanen2, Kim Vettenranta1. 1. a Division of Hematology-Oncology and Stem Cell Transplantation , Children's Hospital, Helsinki University Central Hospital, University of Helsinki , Finland. 2. b Department of Pediatrics , University of Turku , Turku , Finland. 3. c Department of Pediatrics , Porvoo Hospital , Porvoo , Finland. 4. d Department of Virology , University of Helsinki , Helsinki , Finland. 5. e Department of Clinical Virology , Turku University Hospital , Turku , Finland. 6. f Department of Virology , University of Turku , Turku , Finland. 7. g Department of Virology and Immunology , Helsinki University Central Hospital Laboratory Services (HUSLAB) , Helsinki , Finland. 8. h Department of Clinical Microbiology , Karolinska University Hospital , Stockholm , Sweden.
Abstract
BACKGROUND: Viral infections remain the cause of key complications following haematopoietic stem cell transplantation (HSCT). The impact of multiple, concurrent viral reactivations/infections remains to be delineated. METHODS: The clinical correlates of single or multiple viremic infections following HSCT and especially the occurrence of respiratory viruses in the bloodstream were investigated. We retrospectively searched for 23 viruses in a total of 184 sera from 53 paediatric patients. The time-points of interest were pre-HSCT, one, two and three months post-HSCT, and at discharge or death. The viruses were analyzed by quantitative or qualitative PCR. RESULTS: Of the 53 patients, 13 (25%) had viraemias by multiple viruses and 27 (51%) by a single virus. Thirteen patients (25%) had no viruses detected by PCR during the study period. In the children with viremic co-infections, polyomaviruses predominated over herpes viruses. Nearly half the patients, 24/53 (45%) had a polyomavirus in their serum at one or more time-points. At 12/15 time-points and in 11/13 patients with co-infections polyomaviruses were involved, compared with 6/15 time-points and 6/13 patients for cytomegalovirus. Acute graft-versus-host disease (GvHD) and steroid use were significant risk factors for the viraemias caused by more than one virus. CONCLUSIONS: Viral co-detection is a common finding in children undergoing HSCT. With large-scale viral screening also viruses other than CMV could be found as potential pathogens. In this study, BKPyV predominated over CMV as a contributor in viraemias caused by multiple viruses in children receiving HSCT.
BACKGROUND:Viral infections remain the cause of key complications following haematopoietic stem cell transplantation (HSCT). The impact of multiple, concurrent viral reactivations/infections remains to be delineated. METHODS: The clinical correlates of single or multiple viremic infections following HSCT and especially the occurrence of respiratory viruses in the bloodstream were investigated. We retrospectively searched for 23 viruses in a total of 184 sera from 53 paediatric patients. The time-points of interest were pre-HSCT, one, two and three months post-HSCT, and at discharge or death. The viruses were analyzed by quantitative or qualitative PCR. RESULTS: Of the 53 patients, 13 (25%) had viraemias by multiple viruses and 27 (51%) by a single virus. Thirteen patients (25%) had no viruses detected by PCR during the study period. In the children with viremic co-infections, polyomaviruses predominated over herpes viruses. Nearly half the patients, 24/53 (45%) had a polyomavirus in their serum at one or more time-points. At 12/15 time-points and in 11/13 patients with co-infections polyomaviruses were involved, compared with 6/15 time-points and 6/13 patients for cytomegalovirus. Acute graft-versus-host disease (GvHD) and steroid use were significant risk factors for the viraemias caused by more than one virus. CONCLUSIONS: Viral co-detection is a common finding in children undergoing HSCT. With large-scale viral screening also viruses other than CMV could be found as potential pathogens. In this study, BKPyV predominated over CMV as a contributor in viraemias caused by multiple viruses in children receiving HSCT.
Authors: Jeremy D Rubinstein; Carolyn Lutzko; Thomas Leemhuis; Xiang Zhu; Giang Pham; Lorraine Ray; Shawn Thomas; Celeste Dourson; Jamie Wilhelm; Adam Lane; Jose A Cancelas; Dakota Lipps; Justin Ferrell; Patrick J Hanley; Michael D Keller; Catherine M Bollard; YunZu M Wang; Stella M Davies; Adam S Nelson; Michael S Grimley Journal: Blood Adv Date: 2022-05-10