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Practice patterns and incidence of adenovirus infection in allogeneic hematopoietic cell transplant recipients: Multicenter survey of transplant centers in the United States
Author(s) -
Papanicolaou Genovefa A.,
Dvorak Christopher C.,
Dadwal Sanjeet,
Maron Gabriela,
Prasad Vinod K.,
Giller Roger,
AbdelAzim Hisham,
Sadanand Arhanti,
Casciano Roman,
Chandak Aastha,
Huang Shengnan,
Nichols Garrett,
Brundage Tom,
Vainorius Enrikas,
Mozaffari Essy,
Hutcheson Robert
Publication year - 2020
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13283
Subject(s) - medicine , incidence (geometry) , viremia , hematopoietic cell , transplantation , hematopoietic stem cell transplantation , young adult , pediatrics , intensive care medicine , immunology , haematopoiesis , stem cell , human immunodeficiency virus (hiv) , physics , biology , optics , genetics
Background Adenovirus (AdV) is increasingly recognized as a threat to successful outcomes after allogeneic hematopoietic cell transplantation (allo‐HCT). Guidelines have been developed to inform AdV screening and treatment practices, but the extent to which they are followed in clinical practice in the United States is still unknown. The incidence of AdV in the United States is also not well documented. The main objectives of the AdVance US study were thus to characterize current AdV screening and treatment practices in the United States and to estimate the incidence of AdV infection in allo‐HCT recipients across multiple pediatric and adult transplant centers. Methods Fifteen pediatric centers and 6 adult centers completed a practice patterns survey, and 15 pediatric centers and four adult centers completed an incidence survey. Results The practice patterns survey results confirm that pediatric transplant centers are more likely than adult centers to routinely screen for AdV, and are also more likely to have a preemptive AdV treatment approach compared to adult centers. Perceived risk of AdV infection is a determining factor for whether routine screening and preemptive treatment are implemented. Most pediatric centers screen higher‐risk patients for AdV weekly, in blood, and have a preemptive AdV treatment approach. The incidence survey results show that from 2015 to 2017, a total of 1230 patients underwent an allo‐HCT at the 15 pediatric transplant centers, and 1815 patients underwent an allo‐HCT at the 4 adult transplant centers. The incidences of AdV infection, AdV viremia, and AdV viremia ≥ 1000 copies/mL within 6 months after the first allo‐HCT were 23%, 16%, and 9%, respectively, for patients at pediatric centers, and 5%, 3%, and 2%, respectively, for patients at adult centers. Conclusions These findings provide a more recent estimate of the incidence of AdV infection in the United States, as well as a multicenter view of practice patterns around AdV infection screening and intervention criteria, in pediatric and adult allo‐HCT recipients.