Viral Findings in Adult Hematological Patients with Neutropenia
Identifieur interne : 001293 ( Main/Exploration ); précédent : 001292; suivant : 001294Viral Findings in Adult Hematological Patients with Neutropenia
Auteurs : Lars Öhrmalm [Suède] ; Michelle Wong [Suède] ; Carl Aust [Suède] ; Per Ljungman [Suède] ; Oscar Norbeck [Suède] ; Kristina Broliden [Suède] ; Thomas Tolfvenstam [Suède]Source :
- PLoS ONE [ 1932-6203 ] ; 2012.
Abstract
Until recently, viral infections in patients with hematological malignancies were concerns primarily in allogeneic hematopoietic stem cell transplant (HSCT) recipients. During the last years, changed treatment regimens for non-transplanted patients with hematological malignancies have had potential to increase the incidence of viral infections in this group. In this study, we have prospectively investigated the prevalence of a broad range of respiratory viruses in nasopharyngeal aspirate (NPA) as well as viruses that commonly reactivate after allogeneic HSCT.
Patients with hematological malignancies and therapy induced neutropenia (n = 159) were screened regarding a broad range of common respiratory viruses in the nasopharynx and for viruses commonly detected in severely immunosuppressed patients in peripheral blood. Quantitative PCR was used for detection of viruses. A viral pathogen was detected in 35% of the patients. The detection rate was rather similar in blood (22%) and NPA (18%) with polyoma BK virus and rhinovirus as dominating pathogens in blood and NPA, respectively. Patients with chronic lymphocytic leukemia (CLL) (p<0.01) and patients with fever (p<0.001) were overrepresented in the virus-positive group. Furthermore, viral findings in NPA were associated with upper respiratory symptoms (URTS) (p<0.0001).
Both respiratory viral infections and low titers of viruses in blood from patients with neutropenia were common. Patients with CLL and patients with fever were independently associated to these infections, and viral findings in NPA were associated to URTS indicating active infection. These findings motivate further studies on viruses' impact on this patient category and their potential role as causative agents of fever during neutropenia.
Url:
DOI: 10.1371/journal.pone.0036543
PubMed: 22570724
PubMed Central: 3343003
Affiliations:
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Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Wong, Michelle" sort="Wong, Michelle" uniqKey="Wong M" first="Michelle" last="Wong">Michelle Wong</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Aust, Carl" sort="Aust, Carl" uniqKey="Aust C" first="Carl" last="Aust">Carl Aust</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Ljungman, Per" sort="Ljungman, Per" uniqKey="Ljungman P" first="Per" last="Ljungman">Per Ljungman</name><affiliation wicri:level="3"><nlm:aff id="aff2"><addr-line>Division of Hematology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Division of Hematology, Department of Medicine, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff3"><addr-line>Hematology Centre, Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Hematology Centre, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Norbeck, Oscar" sort="Norbeck, Oscar" uniqKey="Norbeck O" first="Oscar" last="Norbeck">Oscar Norbeck</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Broliden, Kristina" sort="Broliden, Kristina" uniqKey="Broliden K" first="Kristina" last="Broliden">Kristina Broliden</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Tolfvenstam, Thomas" sort="Tolfvenstam, Thomas" uniqKey="Tolfvenstam T" first="Thomas" last="Tolfvenstam">Thomas Tolfvenstam</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Until recently, viral infections in patients with hematological malignancies were concerns primarily in allogeneic hematopoietic stem cell transplant (HSCT) recipients. During the last years, changed treatment regimens for non-transplanted patients with hematological malignancies have had potential to increase the incidence of viral infections in this group. In this study, we have prospectively investigated the prevalence of a broad range of respiratory viruses in nasopharyngeal aspirate (NPA) as well as viruses that commonly reactivate after allogeneic HSCT.</p></sec><sec><title>Methodology/Principal Findings</title><p>Patients with hematological malignancies and therapy induced neutropenia (n = 159) were screened regarding a broad range of common respiratory viruses in the nasopharynx and for viruses commonly detected in severely immunosuppressed patients in peripheral blood. Quantitative PCR was used for detection of viruses. A viral pathogen was detected in 35% of the patients. The detection rate was rather similar in blood (22%) and NPA (18%) with polyoma BK virus and rhinovirus as dominating pathogens in blood and NPA, respectively. Patients with chronic lymphocytic leukemia (CLL) (p<0.01) and patients with fever (p<0.001) were overrepresented in the virus-positive group. Furthermore, viral findings in NPA were associated with upper respiratory symptoms (URTS) (p<0.0001).</p></sec><sec><title>Conclusions/Significance</title><p>Both respiratory viral infections and low titers of viruses in blood from patients with neutropenia were common. Patients with CLL and patients with fever were independently associated to these infections, and viral findings in NPA were associated to URTS indicating active infection. These findings motivate further studies on viruses' impact on this patient category and their potential role as causative agents of fever during neutropenia.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Martin, Et" uniqKey="Martin E">ET Martin</name></author><author><name sortKey="Kuypers, J" uniqKey="Kuypers J">J Kuypers</name></author><author><name sortKey="Wald, A" uniqKey="Wald A">A Wald</name></author><author><name sortKey="Englund, Ja" uniqKey="Englund J">JA Englund</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Englund, J" uniqKey="Englund J">J Englund</name></author><author><name sortKey="Feuchtinger, T" uniqKey="Feuchtinger T">T Feuchtinger</name></author><author><name sortKey="Ljungman, P" uniqKey="Ljungman P">P Ljungman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arola, M" uniqKey="Arola M">M Arola</name></author><author><name 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Laskin</name></author><author><name sortKey="Goebel, J" uniqKey="Goebel J">J Goebel</name></author><author><name sortKey="Davies, Sm" uniqKey="Davies S">SM Davies</name></author><author><name sortKey="Yin, Hj" uniqKey="Yin H">HJ Yin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fairchok, Mp" uniqKey="Fairchok M">MP Fairchok</name></author><author><name sortKey="Martin, Et" uniqKey="Martin E">ET Martin</name></author><author><name sortKey="Chambers, S" uniqKey="Chambers S">S Chambers</name></author><author><name sortKey="Kuypers, J" uniqKey="Kuypers J">J Kuypers</name></author><author><name sortKey="Behrens, M" uniqKey="Behrens M">M Behrens</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ljungman, P" uniqKey="Ljungman P">P Ljungman</name></author><author><name sortKey="Ward, Kn" uniqKey="Ward K">KN Ward</name></author><author><name sortKey="Crooks, Bn" uniqKey="Crooks B">BN Crooks</name></author><author><name sortKey="Parker, A" uniqKey="Parker A">A Parker</name></author><author><name sortKey="Martino, R" uniqKey="Martino R">R Martino</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chakrabarti, S" uniqKey="Chakrabarti S">S Chakrabarti</name></author><author><name sortKey="Mautner, V" uniqKey="Mautner V">V Mautner</name></author><author><name sortKey="Osman, H" uniqKey="Osman H">H Osman</name></author><author><name sortKey="Collingham, Ke" uniqKey="Collingham K">KE Collingham</name></author><author><name sortKey="Fegan, Cd" uniqKey="Fegan C">CD Fegan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hakki, M" uniqKey="Hakki M">M Hakki</name></author><author><name sortKey="Riddell, Sr" uniqKey="Riddell S">SR Riddell</name></author><author><name sortKey="Storek, J" uniqKey="Storek J">J Storek</name></author><author><name sortKey="Carter, Ra" uniqKey="Carter R">RA Carter</name></author><author><name sortKey="Stevens Ayers, T" uniqKey="Stevens Ayers T">T Stevens-Ayers</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Engstrand, M" uniqKey="Engstrand M">M Engstrand</name></author><author><name sortKey="Lidehall, Ak" uniqKey="Lidehall A">AK Lidehall</name></author><author><name sortKey="Totterman, Th" uniqKey="Totterman T">TH Totterman</name></author><author><name sortKey="Herrman, B" uniqKey="Herrman B">B Herrman</name></author><author><name sortKey="Eriksson, Bm" uniqKey="Eriksson B">BM Eriksson</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Suède</li></country><region><li>Svealand</li></region><settlement><li>Stockholm</li></settlement></list><tree><country name="Suède"><region name="Svealand"><name sortKey="Ohrmalm, Lars" sort="Ohrmalm, Lars" uniqKey="Ohrmalm L" first="Lars" last="Öhrmalm">Lars Öhrmalm</name></region><name sortKey="Aust, Carl" sort="Aust, Carl" uniqKey="Aust C" first="Carl" last="Aust">Carl Aust</name><name sortKey="Broliden, Kristina" sort="Broliden, Kristina" uniqKey="Broliden K" first="Kristina" last="Broliden">Kristina Broliden</name><name sortKey="Ljungman, Per" sort="Ljungman, Per" uniqKey="Ljungman P" first="Per" last="Ljungman">Per Ljungman</name><name sortKey="Ljungman, Per" sort="Ljungman, Per" uniqKey="Ljungman P" first="Per" last="Ljungman">Per Ljungman</name><name sortKey="Norbeck, Oscar" sort="Norbeck, Oscar" uniqKey="Norbeck O" first="Oscar" last="Norbeck">Oscar Norbeck</name><name sortKey="Tolfvenstam, Thomas" sort="Tolfvenstam, Thomas" uniqKey="Tolfvenstam T" first="Thomas" last="Tolfvenstam">Thomas Tolfvenstam</name><name sortKey="Wong, Michelle" sort="Wong, Michelle" uniqKey="Wong M" first="Michelle" last="Wong">Michelle Wong</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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