Viral infections in children undergoing hematopoietic stem cell transplantation: report 2016 of Polish Pediatric Infectious Working Group of Polish Society of Pediatric Oncology and Hematology
BackgroundPolish Pediatric Infectious Working Group of Polish Society of Pediatric Oncology and Hematology continues from 2012 the infections monitoring program in pediatric hematopoietic stem cell transplant (HSCT) and onco-hematology centers.ObjectiveEpidemiological analysis of viral infections in children and adolescents undergoing HSCT in pediatric centers in 2012–2013 and 2014–2015.MethodsRetrospective analysis of viral infections after 650 HSCT in children and adolescents.ResultsAn increase in incidence in 2014–2015 was observed (60.6% vs 51.3%; OR=1.5; p=0.035) after allo-HSCT. Cumulative incidence after allo-HSCT (2012–2013 vs. 2014–2015) was: CMV – 28.0% vs. 29.2%, BKV – 18.5% vs. 22.8%, EBV – 15.5% vs. 24.3%, ADV – 9.5% vs. 5.2%, rotavirus – 9.1% vs. 5.6%, VZV – 2.6% vs. 1.1%, influenza – 0.9% vs. 3.4%, HHV6 – 0.9% vs. 1.5%, norovirus – 0% vs. 2.2%, RSV – 0% vs. 1.5%, parainfluenza – 0% vs. 0.7%, and MPV – 0% vs 0.4%. Infections after auto-HSCT occurred in 8 (10.5%) patients between 2012 and 2013 vs. 2 (2.6%) between 2014 and 2015. Cure rate after viral infections has increased (2012–2013 vs. 2014–2015) for: EBV – 90.7% vs. 100%, ADV – 93.8% vs. 100%, BKV – 94.2% vs. 96.8%, CMV – 94.6% vs. 98%, and remained 100% in infections with influenza, VZV, HHV6, rotavirus as well as in parainfluenza, RSV, and MPV. Decrease of deaths rate attributed to viral infections from 6.5% (2012–2013) to 0.7% (2014–2015) was observed after allo-HSCT.ConclusionsWe found epidemiological trends in viral infections after HSCT in children: increase in incidence after allo-HSCT (increase EBV, appearance of CARV) and decrease after auto-HSCT. Decrease of deaths attributed to viral infections was observed in the last period of time
