Dept. of Haematology, Karolinska University Hospital, Stockholm, Sweden.
Haematologica. 2011 Aug;96(8):1231-5. doi: 10.3324/haematol.2011.041913. Epub 2011 May 5.
During 2009, a new strain of A/H1N1 influenza appeared and became pandemic. A prospective study was performed to collect data regarding risk factors and outcome of A/H1N1 in hematopoietic stem cell transplant recipients. Only verified pandemic A/H1N1 influenza strains were included: 286 patients were reported, 222 allogeneic and 64 autologous recipients. The median age was 38.3 years and the median time from transplant was 19.4 months. Oseltamivir was administered to 267 patients and 15 patients received zanamivir. One hundred and twenty-five patients (43.7%) were hospitalized. Ninety-three patients (32.5%) developed lower respiratory tract disease. In multivariate analysis, risk factors were age (OR 1.025; 1.01-1.04; P=0.002) and lymphopenia (OR 2.49; 1.33-4.67; P<0.001). Thirty-three patients (11.5%) required mechanical ventilation. Eighteen patients (6.3%) died from A/H1N1 infection or its complications. Neutropenia (P=0.03) and patient age (P=0.04) were significant risk factors for death. The 2009 A/H1N1 influenza pandemic caused severe complications in stem cell transplant recipients.
2009 年，一种新型 A/H1N1 流感出现并流行。一项前瞻性研究旨在收集关于造血干细胞移植受者中 A/H1N1 流感的危险因素和结果的数据。仅包括已证实的大流行 A/H1N1 流感株：报告了 286 例患者，其中 222 例为异基因和 64 例为自体受者。中位年龄为 38.3 岁，移植后中位时间为 19.4 个月。267 例患者接受了奥司他韦治疗，15 例患者接受了扎那米韦治疗。125 例患者（43.7%）住院。93 例患者（32.5%）发生下呼吸道疾病。多变量分析显示，危险因素为年龄（OR 1.025；1.01-1.04；P=0.002）和淋巴细胞减少（OR 2.49；1.33-4.67；P<0.001）。33 例患者（11.5%）需要机械通气。18 例患者（6.3%）死于 A/H1N1 感染或其并发症。中性粒细胞减少症（P=0.03）和患者年龄（P=0.04）是死亡的显著危险因素。2009 年 A/H1N1 流感大流行导致干细胞移植受者发生严重并发症。
