Virus infection facilitates the development of severe pneumonia in transplant patients with hematologic malignancies

// Caifeng Yue 1, 2, 3, * , ZhiJie Kang 1, 2, 3, 4, * , Kexin Ai 1, 2, 3, * , Duorong Xu 5 , Jim Wu 6 , Yujia Pan 1, 2, 3 , JinSong Yan 4 , Min Liu 1, 2, 3 , Quentin Liu 1, 2, 3 1 Department of Hematology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China 2 Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China 3 Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China 4 Department of Hematology, The Second Affiliated Hospital, Dalian Medical University, Dalian, China 5 Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China 6 Roche Pharmaceutical Research and Early Development, Shanghai, China * These authors have contributed equally to this work Correspondence to: Quentin Liu, email: liuq9@mail.sysu.edu.cn Keywords: cytomegalovirus (CMV), respiratory syncytial virus (RSV), co-infection, severe pneumonia, hematologic malignancies Received: November 04, 2015     Accepted: May 16, 2016     Published: June 20, 2016 ABSTRACT Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective therapy for patients with hematologic malignancies. Severe pneumonia is associated with high mortality rate in HSCT recipients. Viral co-infection indicates a poor prognosis of HSCT recipients. In this study, a total of 68 allogeneic HSCT recipients were included. Cytomegalovirus (CMV) and Respiratory syncytial virus (RSV) infection was assessed by testing peripheral blood and oropharynx swabs, respectively, collected in the first 180 days after transplantation. We analysed the correlation of CMV and RSV co-infection with severe pneumonia and mortality. The incidence of CMV and RSV co-infection was 26.5% (18/68). Severe pneumonia was diagnosed in 61% (11/18) cases with co-infection compared to only 10% (5/50) cases with mono-infection or no infection. The analysis of potential risk factors for severe pneumonia showed that CMV and RSV co-infection was significantly associated with severe pneumonia ( p < 0.001). The 5 patients who died of severe pneumonia were all co-infected with CMV and RSV. In conclusion, CMV and RSV co-infection appears to be an important factor and facilitates the development of severe pneumonia in allogeneic HSCT patients with hematologic malignancies.