The clinical features and outcome of 2009 H1N1 influenza infection in Allo-SCT patients: a British Society of Blood and Marrow Transplantation study

• Published in: Bone marrow transplantation (Basingstoke) Vol. 47; no. 1; pp. 88 - 94
• Main Authors: Protheroe, R E, Kirkland, K E, Pearce, R M, Kaminaris, K, Bloor, A, Potter, M N, Nagra, S, Gilleece, M H, McQuaker, I G, Jackson, G, Cook, G, Marks, D I
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.01.2012; Nature Publishing Group
• Subjects: Adolescent; Adult; Age; Age Factors; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood; Bone marrow; Bone Marrow Transplantation; Bone marrow, stem cells transplantation. Graft versus host reaction; Cell Biology; Child; Child, Preschool; Cohort Studies; Critical Care; Data processing; Development and progression; Diagnosis; Disease-Free Survival; Female; Geriatrics; Hematology; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infant; Infectious diseases; Influenza; Influenza A Virus, H1N1 Subtype; Influenza, Human - mortality; Influenza, Human - therapy; Intensive care units; Internal Medicine; Lung diseases; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Morbidity; Mortality; original-article; Pandemics; Patient outcomes; Pneumonia; Pneumonia - mortality; Pneumonia - therapy; Public Health; Risk factors; Societies, Medical; Stem Cell Transplantation; Stem Cells; Survival Rate; Swine influenza; Time Factors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation, Homologous; United Kingdom; United Kingdom - epidemiology; Viral diseases; Viral diseases of the respiratory system and ent viral diseases; United Kingdom; risk factors; immunocompromised; pneumonia; H1N1 influenza; Allo-SCT; Human; Immunopathology; Lung disease; Pneumonia; Prognosis; Hematology; Respiratory disease; Stem cell; Hematopoietic cell; Clinical form; Homograft; Epidemiology; Immune deficiency; Blood; Infection; Allogeneic hematopoietic stem cell transplantation; Viral disease; Risk factor; Graft
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2011.12

The clinical course of 2009 H1N1 influenza in Allo-SCT patients is unknown. Data were collected in the UK from October 2009 to April 2010 on laboratory-confirmed cases of H1N1 influenza in Allo-SCT recipients. H1N1 infection was diagnosed in 60 patients, median age 42 years, at a median of 10 months post-SCT. Twenty-one patients (35%) developed pneumonia and nine (15%) required admission to intensive care units. Actuarial mortality was 7% at 28 days and 19% 4 months post-diagnosis of 2009 H1N1 influenza. Increasing age and pre-existing lung disease were risk factors for pneumonia ( P =0.006 and 0.037, respectively); older age was a risk factor for death ( P =0.012). Morbidity and mortality from 2009 H1N1 influenza in SCT patients exceeds that of immunocompetent patients, but parallels that in other critically ill hospitalised cohorts; the elderly and those with chronic pulmonary disease are at greatest risk.