TY - JOUR
T1 - Practice patterns and incidence of adenovirus infection in allogeneic hematopoietic cell transplant recipients
T2 - Multicenter survey of transplant centers in the United States
AU - Papanicolaou, Genovefa A.
AU - Dvorak, Christopher C.
AU - Dadwal, Sanjeet
AU - Maron, Gabriela
AU - Prasad, Vinod K.
AU - Giller, Roger
AU - Abdel-Azim, Hisham
AU - Sadanand, Arhanti
AU - Casciano, Roman
AU - Chandak, Aastha
AU - Huang, Shengnan
AU - Nichols, Garrett
AU - Brundage, Tom
AU - Vainorius, Enrikas
AU - Mozaffari, Essy
AU - Hutcheson, Robert
N1 - Funding Information:
The authors would like to thank Artak Khachatryan for assistance with the initial study design and Nadia Petiot for management of the survey database. We would also like to thank the physicians and support staff from the following centers who participated in the survey: Ann and Robert H Lurie Children's Hospital, Chicago, IL; Children Hospital Los Angeles, Los Angeles, CA; Children's Healthcare of Atlanta, Atlanta, GA; Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA; City of Hope National Medical Center, Duarte, CA; Duke University Medical Center, Durham, NC; Medical College of Wisconsin, Milwaukee, WI; Memorial Sloan Kettering Cancer Center, New York, NY; St Jude Children's Research Hospital, Memphis, TN; St-Louis Children's Hospital, St-Louis, MO; Benioff Children's Hospital, University of California, San Francisco, CA; University of Chicago, Chicago, IL; University of Colorado Pediatrics, Aurora, CO; University of Nebraska Medical Center, Omaha, NE; and Vanderbilt University Medical Center, Nashville, TN.
Publisher Copyright:
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2020/8/1
Y1 - 2020/8/1
N2 - 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.
AB - 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.
KW - adenovirus
KW - adult
KW - allogeneic hematopoietic cell transplantation
KW - incidence
KW - pediatric
KW - preemptive
KW - screening
KW - treatment
KW - United States
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U2 - 10.1111/tid.13283
DO - 10.1111/tid.13283
M3 - Article
C2 - 32267590
AN - SCOPUS:85084063188
SN - 1398-2273
VL - 22
JO - Transplant Infectious Disease
JF - Transplant Infectious Disease
IS - 4
M1 - e13283
ER -