1198. Human Metapneumovirus (hMPV) infections in 135 Cancer Patients
Session: Poster Abstract Session: Transplant: Epidemiology of Infections in Transplant Patients and Other Patients with Impaired Immunity
Friday, October 9, 2015
Room: Poster Hall

Background:

hMPV infection is often associated with upper and lower respiratory tract infections (URI and LRI) in immunocompetent young children and older adults. Data on the impact of hMPV infections in cancer patients has been scarce. We aimed to determine the morbidity and mortality of hMPV infections in cancer patients.

Methods:

We reviewed all 135 cancer patients with positive hMPV testing from April 2012 to April 2015 and collected demographics, clinical characteristics and outcomes of hMPV infections. Multivariable logistic regression (MVA) analyses were conducted to identify risk factors associated with hMPV-LRI in cancer patients.

Results:

Most of patients were hematopoietic cell transplant recipients (50%) or had hematologic malignancies (34%), and the rest had solid tumors (16%). Majority of patients were Caucasians (62%), males (64%) with a median age of 59 years (range: 1 to 88 years). Majority of infections were community-acquired (87%), presented at the URI stage (65%) and overall LRI rate was 44%. Hospital admission secondary to infection (46%), mechanical ventilation (7%), and oxygen requirements (29%) were observed. On MVA, risk factors for LRI were nosocomial infection and hypoxia at presentation (P<0.05). At day 30, all-cause and hMPV associated mortality was low (3% vs. 2%, respectively). Details of 8 patients who died within 90 days of hMPV diagnosis are depicted in table.

Conclusion:

hMPV infections in cancer patients can cause significant morbidity leading to high rates of LRI and hospital admissions. Although no antiviral therapy is currently available for this infection, mortality rate remains low especially in patients after Stem cell transplant or hematologic malignancies.

 

Table:

 

 

Cause of death

Time from hMPV diagnosis to death

LRI

Nosocomial

Lymphocytopenia

Neutropenia

Mechanical ventilation

Antiviral therapy

1

Respiratory failure

22

yes

no

yes

no

no

Ribavirin and IVIG at LRI stage

2

Refractory ALL

38

yes

yes

yes

 

no

none

3

Cancer Relapse

45

no

no

no

yes

no

none

4

Respiratory failure

36

yes

yes

no

yes

no

none

5

Cancer Relapse

13

yes

yes

no

no

no

none

6

Cancer Relapse

15

yes

no

no

no

yes

none

7

Progressive leukemia and respiratory failure

1

yes

yes

no

no

yes

none

8

Respiratory failure

5

yes

yes

yes

no

no

none

 

Firas El Chaer, MD, Infectious Diseases, Baylor College of Medicine, Houston, TX, Dimpy P. Shah, MD, MSPH, Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, Joumana Kmeid, MD, Infectious Diseases, MD Anderson Cancer Center, Houston, TX, Ella Ariza-Heredia, MD, Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, Chitra Hosing, MD, Stem Cell Transplantation Research, The University of Texas MD Anderson Cancer Center, Houston, TX and Roy Chemaly, MD, MPH, Infectious Disease, The University of Texas MD Anderson Cancer Center, Houston, TX

Disclosures:

F. El Chaer, None

D. P. Shah, None

J. Kmeid, None

E. Ariza-Heredia, None

C. Hosing, None

R. Chemaly, None

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