Monitoring of adenoviremia in pediatric patients undergoing hematopoietic stem cell transplantation: Is it alone sufficient to predict adenoviral disease?

• Published in: Pediatric transplantation Vol. 28; no. 1; pp. e14696 - n/a
• Main Authors: Kanık Yüksek, Saliha, Arman Bilir, Özlem, Erat, Tuğba, Gülhan, Belgin, Kanbur, Şerife Mehtap, Bayhan, Gülsüm İclal, Ok Bozkaya, İkbal, Özkaya Parlakay, Aslınur, Özbek, Namık Yaşar
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.02.2024
• Subjects: adenovirus; adenovirus disease; Graft-versus-host reaction; hematopoietic stem cell transplantation; Hematopoietic stem cells; monitoring; Mortality; Patients; pediatric; Pediatrics; Risk factors; Stem cell transplantation; Viremia; hematopoietic stem cell transplantation; adenovirus disease; monitoring; viremia; adenovirus; pediatric
• ISSN: 1397-3142; 1399-3046
• DOI: 10.1111/petr.14696

Background We aimed to evaluate our pediatric HSCT recipients routinely monitored for adenoviremia and to determine the adequacy of this monitoring in predicting adenoviral disease (AD). Methods A retrospective cohort of patients who underwent allogeneic HSCT between January 2021 and August 2022, and routinely monitored for adenoviremia by real‐time PCR was included in our survey. Demographic and clinical data of the patients were recorded. Incidence rates, risk factors, and mortality rates related to adenoviremia, and AD were analyzed. Results Among 104 HSCTs performed in 94 patients adenovirus (AdV) was revealed in 27 (26%) episodes and adenoviremia in 18 (17.3%) HSCT episodes. AD without adenoviremia developed in nine episodes (8.6%). Disseminated disease was significantly more frequently detected in episodes with adenoviremia (p = .008). GVHD was independent risk factor for AdV detection (OR: 8.6, 95% CI: 2.03–33.7, p = .001). Viremia developed within a shorter time interval after HSCT in isolated episodes of adenoviremia compared to those with concomitant AD (p = .006). Initial and peak viral loads were significantly higher in adenoviremia with AD (p < .001). Mortality was higher in the AdV‐detected episodes (p < .001) than in the AdV‐undetected episodes. AdV‐related mortality was found to be 22.2%. Adenoviremia increased the risk of mortality (OR: 1.2, 95% CI: 0.22–1.33, p = .01). Conclusions Adenoviremia monitoring is an important process in the detection of AD. Since some patients may develop AD without accompanying by adenoviremia, monitoring for AdV in blood samples should be supported with other monitoring methods in order to evaluate the probable involvement of different organs or systems.