Characterizing Respiratory Virus Infections during the Peri-engraftment Period of Allogeneic Hematopoietic Cell Transplant.

Characterizing Respiratory Virus Infections during the Peri-engraftment Period of Allogeneic Hematopoietic Cell Transplant.

Publication date: Sep 11, 2025

Community-acquired respiratory virus (CARV) infections are frequent and potentially severe in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients. However, their impact during the peri-engraftment period remains underexplored. In this retrospective multicenter study, we assessed the characteristics, effects on neutrophil engraftment, and risk factors for lower respiratory tract disease (LRTD) progression and 100-day mortality of symptomatic peri-engraftment CARV infections [from Day -8 until Day +36 after stem cell infusion]. A total of 112 allo-HCT recipients and 114 CARV episodes were included. Univariable and multivariable Cox regression analyses and cumulative incidence estimates were used. The median patient age was 51 years. Rhinovirus (47%) and respiratory syncytial virus (23%) were the most common pathogens. Half of the infections occurred before neutrophil engraftment (median day +18), and 50% progressed to LRTD. The 100-day mortality rate was 17%, increasing to 27% in those with LRTD. CARV infection prior to engraftment was associated with delayed neutrophil recovery (Day +18 vs. +16; p = 0. 04) in multivariable cause-specific Cox regression analysis (HR 0. 42, p

Concepts Keywords
Hematopoietic CARV
Retrospective coronavirus
Rhinovirus human metapneumovirus
Underexplored immunodeficiency scoring index
influenza
parainfluenza virus
respiratory viral infection
rhinovirus
RVS

Semantics

Type Source Name
disease MESH Virus Infections
disease IDO cell
disease MESH infections
disease IDO infection
disease IDO immunodeficiency
disease MESH influenza
disease MESH parainfluenza

Original Article

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