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Hematopoietic stem cell transplantation may increase risk for morbidity, mortality among people with leukemia
People who are undergoing hematopoietic stem cell transplantation or therapy for hematologic malignancies are at increased risk for parainfluenza virus, and there is currently no licensed prophylaxis or antiviral therapy for treatment of severe parainfluenza virus infections.
“Parainfluenza virus could be a significant cause of mortality and morbidity in these patients, and since we don’t have a definitive vaccine prophylaxis or an effective treatment modality as of now, infection control remains the single most important strategy in preventing parainfluenza virus infection in this patient group,” said Roy F. Chemaly, MD, MPH, associate professor of medicine in the department of infectious diseases, infection control and employee health at The University of Texas M.D. Anderson Cancer Center.
In a retrospective study, Chemaly and colleagues reviewed records of 200 patients aged 17 to 84 years with parainfluenza virus from November 2002 to June 2007.
Eighty patients had leukemia and 120 received hematopoietic stem cell transplantation.
In addition to examining the characteristics of patients with parainfluenza virus infection who also had leukemia and hematopoietic stem cell transplant, the researchers assessed the role of aerosolized ribavirin in reducing the duration of symptoms and prevention of progress from upper respiratory tract infection to pneumonia.
“We found that aerosolized ribavirin was not effective either in reducing the duration of symptoms of parainfluenza infection or preventing the progress from upper respiratory tract infection to pneumonia in our patient population,” Chemaly said. “However, in our retrospective study, aerosolized ribavirin was used in a relatively small number of patients. There could be an element of selection bias where those patients who were most sick at presentation may have been subjected to the treatment with aerosolized ribavirin.”
He said that randomized controlled trials will be more helpful before coming to a definite conclusion.
Presented at: ICAAC/IDSA joint meeting. Oct. 25-28, 2008. Washington, DC.