Clinical Characteristics and Outcomes of Influenza-Associated Late-Onset Severe Pneumonia After Allogeneic Hematopoietic Stem Cell Transplantation

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-08-20 DOI:10.1111/ctr.70287

Yuewen Wang, Leqing Cao, Xiaohui Zhang, Lanping Xu, Yu Wang, Chenhua Yan, Huan Chen, Yuhong Chen, Wei Han, Fengrong Wang, Jingzhi Wang, Xiaojun Huang, Xiaodong Mo

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Abstract

Background

Late-onset severe pneumonia (LOSP) is one of the most important causes of mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The influenza virus is a frequent viral pathogen in patients receiving allo-HSCT, accounting for at least 30% of all respiratory viral infections. We aimed to identify the clinical characteristics and outcomes of influenza-associated LOSP after allo-HSCT.

Methods

This study enrolled 23 patients who underwent allo-HSCT at the Peking University Institute of Hematology and were subsequently diagnosed with influenza-associated LOSP. Survival analysis was conducted via the Kaplan‒Meier method. Potential risk factors for survival and mortality following influenza-associated LOSP were evaluated through univariate and multivariate Cox regression analyses.

Results

Among the patients, 39.1% (n = 9) died following influenza-associated LOSP. The median time from allo-HSCT to influenza infection was 269 days (range 100–3979 days), and the median time from the onset of influenza symptoms to influenza-associated LOSP was 5 days (range 0–38 days). The most common clinical manifestations were fever (95.7%), cough (56.5%), and expectoration (34.8%). After antiviral therapy, the median time for the influenza virus to turn negative was 11 days (range, 4–34 days). The 100-day cumulative incidence of influenza-associated LOSP-related mortality was 30.9% (95% CI 11.3%–50.5%). The probability of overall survival at 100 days after influenza-associated LOSP was 59.1% (95% CI 41.5%–84.0%).

Conclusions

This study presents the first comprehensive analysis of the clinical characteristics and outcomes associated with influenza-related LOSP following allo-HSCT. Additionally, our findings highlight the treatment strategies and prognostic factors associated with influenza-associated LOSP.

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异基因造血干细胞移植后流感相关迟发性重症肺炎的临床特征和结局

背景：迟发性重症肺炎（LOSP）是异基因造血干细胞移植（alloo - hsct）术后死亡的最重要原因之一。在接受同种异体造血干细胞移植的患者中，流感病毒是一种常见的病毒病原体，至少占所有呼吸道病毒感染的30%。我们的目的是确定同种异体造血干细胞移植后流感相关LOSP的临床特征和结果。方法本研究纳入了23例在北京大学血液学研究所接受同种异体造血干细胞移植的患者，这些患者随后被诊断为流感相关的LOSP。生存率分析采用Kaplan-Meier法。通过单因素和多因素Cox回归分析评估流感相关LOSP患者生存和死亡率的潜在危险因素。结果39.1% （n = 9）的患者死于流感相关性LOSP。从同种异体造血干细胞移植到流感感染的中位时间为269天（范围100-3979天），从出现流感症状到流感相关LOSP的中位时间为5天（范围0-38天）。临床表现以发热（95.7%）、咳嗽（56.5%）、咳痰（34.8%）为主。抗病毒治疗后，流感病毒转为阴性的中位时间为11天（范围4-34天）。流感相关losp相关死亡率的100天累积发生率为30.9% （95% CI 11.3%-50.5%）。流感相关LOSP后100天的总生存率为59.1% （95% CI 41.5%-84.0%）。本研究首次全面分析了同种异体造血干细胞移植后流感相关LOSP的临床特征和预后。此外，我们的研究结果强调了与流感相关性LOSP相关的治疗策略和预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.