Natalie J M Dailey Garnes1,2, Dristhi Ragoonanan2, Aya Aboulhosn3. 1. Division of Internal Medicine, Department of Infectious Diseases, Infection Control, and Employee Health. 2. Division of Pediatrics, Department of Pediatrics Patient Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. 3. Department of Pediatrics, Filbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon.
Abstract
PURPOSE OF REVIEW: To provide an update on risk factors associated with adenovirus (ADV) infection in patients after hematopoietic cell transplant (HCT) and on options for ADV monitoring and treatment in the setting of HCT. RECENT FINDINGS: Among patients undergoing HCT, ADV infection continues to be more common amongst those receiving a T-cell-depleted or graft other than from a matched-related donor. Among children undergoing HCT, reactivation in the gastrointestinal tract appears to be the most common source, and the virus is detectable by quantitative PCR in the stool before it is detectable in the blood. Thus, screening for the virus in the stool of these children may allow for preemptive therapy to reduce mortality. Brincidofovir, although still not approved by any regulatory agency, remains a potential agent for preemptive therapy and for salvage in cases not responding to cidofovir. Rapidly generated off-the-shelf virus-specific T cells may facilitate adoptive cell therapy in populations with a special need and previously not eligible for adoptive cell therapy, such as cord blood recipients. SUMMARY: ADV infection continues to adversely affect survival in HCT recipients. Screening stool in children and preemptive therapy may reduce mortality. Brincidofovir and adoptive T-cell therapy remain potential options for treatment.
PURPOSE OF REVIEW: To provide an update on risk factors associated with adenovirus (ADV) infection in patients after hematopoietic cell transplant (HCT) and on options for ADV monitoring and treatment in the setting of HCT. RECENT FINDINGS: Among patients undergoing HCT, ADV infection continues to be more common amongst those receiving a T-cell-depleted or graft other than from a matched-related donor. Among children undergoing HCT, reactivation in the gastrointestinal tract appears to be the most common source, and the virus is detectable by quantitative PCR in the stool before it is detectable in the blood. Thus, screening for the virus in the stool of these children may allow for preemptive therapy to reduce mortality. Brincidofovir, although still not approved by any regulatory agency, remains a potential agent for preemptive therapy and for salvage in cases not responding to cidofovir. Rapidly generated off-the-shelf virus-specific T cells may facilitate adoptive cell therapy in populations with a special need and previously not eligible for adoptive cell therapy, such as cord blood recipients. SUMMARY: ADV infection continues to adversely affect survival in HCT recipients. Screening stool in children and preemptive therapy may reduce mortality. Brincidofovir and adoptive T-cell therapy remain potential options for treatment.
Authors: Michael C Spaeder; Claire Stewart; Matthew P Sharron; Julia R Noether; Natalia Martinez-Schlurman; Robert P Kavanagh; Jessica K Signoff; Michael C McCrory; Daniel B Eidman; Anjali V Subbaswamy; Paul L Shea; Ilana Harwayne-Gidansky; Emily K Ninmer; Mary Lynn Sheram; Christopher M Watson Journal: J Pediatr Intensive Care Date: 2020-10-26
Authors: Chikara Ogimi; Hu Xie; Alpana Waghmare; Keith R Jerome; Wendy M Leisenring; Filippo Milano; Janet A Englund; Michael Boeckh Journal: J Clin Virol Date: 2022-04-04 Impact factor: 14.481