This multivariable analysis from the AdVance multicenter observational study assessed adenovirus (AdV) viremia peak, duration, and overall AdV viral burden—measured as time-averaged area under the viremia curve over 16 weeks (AAUC0-16)—as predictors of all-cause mortality in pediatric allo-HCT recipients with AdV viremia. In the 6 months following allo-HCT, 241 patients had AdV viremia ≥ 1000 copies/ml. Among these, 18% (43/241) died within 6 months of first AdV ≥ 1000 copies/ml. Measures of AdV viral peak, duration, and overall burden of infection consistently correlate with all-cause mortality. In multivariable analyses, controlling for lymphocyte recovery, patients with AdV AAUC0-16 in the highest quartile had a hazard ratio of 11.1 versus the lowest quartile (confidence interval 5.3–23.6); for peak AdV viremia, the hazard ratio was 2.2 for the highest versus lowest quartile. Both the peak level and duration of AdV viremia were correlated with short-term mortality, independent of other known risk factors for AdV-related mortality, such as lymphocyte recovery. AdV AAUC0-16, which assesses both peak and duration of AdV viremia, is highly correlated with mortality under the current standard of care. New therapeutic agents that decrease AdV AAUC0-16 have the potential of reducing mortality in this at-risk patient population.

Association between adenovirus viral load and mortality in pediatric allo-hct recipients. the multinational advance study / Zecca, M.; Wynn, R.; Dalle, J. -H.; Feuchtinger, T.; Vainorius, E.; Brundage, T. M.; Chandak, A.; Mozaffari, E.; Nichols, G.; Locatelli, F.. - In: BONE MARROW TRANSPLANTATION. - ISSN 0268-3369. - 54:10(2019), pp. 1632-1642. [10.1038/s41409-019-0483-7]

Association between adenovirus viral load and mortality in pediatric allo-hct recipients. the multinational advance study

Locatelli F.
2019

Abstract

This multivariable analysis from the AdVance multicenter observational study assessed adenovirus (AdV) viremia peak, duration, and overall AdV viral burden—measured as time-averaged area under the viremia curve over 16 weeks (AAUC0-16)—as predictors of all-cause mortality in pediatric allo-HCT recipients with AdV viremia. In the 6 months following allo-HCT, 241 patients had AdV viremia ≥ 1000 copies/ml. Among these, 18% (43/241) died within 6 months of first AdV ≥ 1000 copies/ml. Measures of AdV viral peak, duration, and overall burden of infection consistently correlate with all-cause mortality. In multivariable analyses, controlling for lymphocyte recovery, patients with AdV AAUC0-16 in the highest quartile had a hazard ratio of 11.1 versus the lowest quartile (confidence interval 5.3–23.6); for peak AdV viremia, the hazard ratio was 2.2 for the highest versus lowest quartile. Both the peak level and duration of AdV viremia were correlated with short-term mortality, independent of other known risk factors for AdV-related mortality, such as lymphocyte recovery. AdV AAUC0-16, which assesses both peak and duration of AdV viremia, is highly correlated with mortality under the current standard of care. New therapeutic agents that decrease AdV AAUC0-16 have the potential of reducing mortality in this at-risk patient population.
2019
multivariable analysis; multicenter observational study; adenovirus viremia
01 Pubblicazione su rivista::01a Articolo in rivista
Association between adenovirus viral load and mortality in pediatric allo-hct recipients. the multinational advance study / Zecca, M.; Wynn, R.; Dalle, J. -H.; Feuchtinger, T.; Vainorius, E.; Brundage, T. M.; Chandak, A.; Mozaffari, E.; Nichols, G.; Locatelli, F.. - In: BONE MARROW TRANSPLANTATION. - ISSN 0268-3369. - 54:10(2019), pp. 1632-1642. [10.1038/s41409-019-0483-7]
File allegati a questo prodotto
File Dimensione Formato  
Zecca_Association-between-adenovirus_2019.pdf

accesso aperto

Note: La natura "Open Access" del "full text" allegato è riportata nella prima e nella penultima pagina della versione editoriale allegata.
Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Creative commons
Dimensione 1.04 MB
Formato Adobe PDF
1.04 MB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1479698
Citazioni
  • ???jsp.display-item.citation.pmc??? 8
  • Scopus 23
  • ???jsp.display-item.citation.isi??? 24
social impact