Immunodeficiency scoring index to predict poor outcomes in hematopoietic cell transplant recipients with RSV infections

Dimpy P. Shah, Shashank S. Ghantoji, Ella J. Ariza-Heredia, Jharna N. Shah, Katia K. El Taoum, Pankil K. Shah, Lior Nesher, Chitra Hosing, Gabriela Rondon, Richard E. Champlin, Roy F. Chemaly

Research output: Contribution to journalArticle

61 Scopus citations

Abstract

We developed an immunodeficiency scoring index for respiratory syncytial virus (ISI-RSV) infection, based on a cohort of 237 allogeneic hematopoietic cell transplant (allo-HCT) recipients, that can predict the risk of progression to lower respiratory tract infection (LRTI) and RSV-associated mortality. A weighted index was calculated using adjusted hazard ratios for immunodeficiency markers. Based on the ISI-RSV (range, 0-12), patients were stratified into low (0-2), moderate (3-6), and high (7-12) risk groups. A significant trend of increasing incidence of LRTI and RSV-associated mortality was observed as the risk increased from low to moderate to high (P < .001). Patients in the high-risk group had the greatest benefit of ribavirin-based therapy at the upper respiratory tract infection stage and the highest risk for progression to LRTI and death when antiviral therapy was not given (6.5 [95% confidence interval (CI), 1.8-23.6] and 8.1 [95% CI, 1.1-57.6], respectively). The ISI-RSV is designed to stratify allo-HCT recipients with RSV infection into groups according to their risk for progression to LRTI and RSVassociated mortality. Identification of high-risk groups using this index would distinguish patients who would benefit the most from antiviral therapy, mainly with aerosolized ribavirin. The ISI-RSV should be validated in a multiinstitutional study.

Original languageEnglish (US)
Pages (from-to)3263-3268
Number of pages6
JournalBlood
Volume123
Issue number21
DOIs
StatePublished - May 22 2014

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Shah, D. P., Ghantoji, S. S., Ariza-Heredia, E. J., Shah, J. N., El Taoum, K. K., Shah, P. K., Nesher, L., Hosing, C., Rondon, G., Champlin, R. E., & Chemaly, R. F. (2014). Immunodeficiency scoring index to predict poor outcomes in hematopoietic cell transplant recipients with RSV infections. Blood, 123(21), 3263-3268. https://doi.org/10.1182/blood-2013-12-541359