Vaccine and Infectious Disease Division

Flu infections after hematopoietic stem cell transplantation

Respiratory virus infections are a major cause of death and morbidity for patients who receive hematopoietic cell (a type of blood stem cell) transplantation; however, the type of transplantation may affect the patient’s ability to fight these infections.  Elderly patients with medical co-morbidities often receive non-myeloablative transplantation, as these regimens are less toxic than traditional myeloablative regimens and can be given in the outpatient setting.  Unlike myeloblative regimens, non-myeloablative regimens do not eliminate all of the patient’s hematopoietic cells and may therefore leave patients better able to fight respiratory infections than patients who receive myeloablative regimens. VIDI senior fellow Dr. Joshua Schiffer, VIDI member Dr. Michael Boeckh, and colleagues studied the incidence and severity of respiratory viral infections in patients who received these two types of regimens.  They found that although the incidence of infection was similar between patients receiving non-myeloablative and myeloablative transplantation, patients who received non-myeloablative regimens were less likely to have life-threatening lower tract respiratory virus infection in the first 100 days after the transplant.  These findings suggest that non-myeloblative regimens may be a treatment option in cases where a patient in need of urgent cancer treatment contracts a respiratory disease prior to the transplantation.

Timing and severity of community acquired respiratory virus infections after myeloablative versus non-myeloablative hematopoietic stem cell transplantation. Schiffer JT, Kirby K, Sandmaier B, Storb R, Corey L, Boeckh M. Haematologica. 2009 Aug 9;94(8):1101-8.