Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
Biol Blood Marrow Transplant. 2013 Aug;19(8):1220-6. doi: 10.1016/j.bbmt.2013.05.005. Epub 2013 May 13.
Human metapneumovirus (HMPV), a common respiratory virus, can cause severe disease in pre- and post-hematopoietic cell transplantation (HCT) recipients. We conducted a retrospective cohort analysis in HCT patients with HMPV (n = 23) or respiratory syncytial virus (n = 23) detected in bronchoalveolar lavage samples by reverse transcription PCR between 2006 and 2011 to determine disease characteristics and factors associated with outcome. Mortality rates at 100 days were 43% for both HMPV and respiratory syncytial virus lower respiratory tract disease. Steroid therapy, oxygen requirement >2 L or mechanical ventilation, and bone marrow as cell source were significant risk factors for overall and virus-related mortality in multivariable models, whereas the virus type was not. The presence of centrilobular/nodular radiographic infiltrates was a possible protective factor for mechanical ventilation. Thus, HMPV lower respiratory tract disease is associated with high mortality in HCT recipients. Earlier detection in combination with new antiviral therapy is needed to reduce mortality among HCT recipients.
人偏肺病毒（HMPV）是一种常见的呼吸道病毒，可导致造血细胞移植（HCT）前后的患者发生严重疾病。我们对 2006 年至 2011 年间通过逆转录 PCR 在支气管肺泡灌洗液样本中检测到 HMPV（n=23）或呼吸道合胞病毒（n=23）的 HCT 患者进行了回顾性队列分析，以确定疾病特征和与结局相关的因素。100 天时，HMPV 和呼吸道合胞病毒下呼吸道疾病的死亡率均为 43%。在多变量模型中，类固醇治疗、>2 L 的氧气需求或机械通气以及骨髓作为细胞来源是总死亡率和病毒相关死亡率的显著危险因素，而病毒类型则不是。小叶中心/结节性放射学浸润的存在可能是机械通气的保护因素。因此，HMPV 下呼吸道疾病与 HCT 受者的高死亡率相关。需要早期检测并结合新的抗病毒治疗来降低 HCT 受者的死亡率。
