The importance of viral infections as a leading cause of morbidity and mortality is well documented in severely immunosuppressed patients undergoing allogeneic stem cell transplantation. By contrast, viral infections generally receive less attention in patients with malignant disorders undergoing chemotherapy, where the onset of neutropenic fever is mostly associated with bacterial or fungal infections, and screening for viral infections is not routinely performed. To address the occurrence of invasive viral infections in a clinical setting commonly associated with less pronounced immunosuppression, we have prospectively screened 237 febrile neutropenic episodes in pediatric (n=77) and adult (n=69) patients undergoing intensive chemotherapy, primarily for treatment of acute leukemia. Serial peripheral blood specimens were tested by RQ-PCR assays for the presence and quantity of clinically relevant viruses CMV, EBV, HHV6 and HAdV, commonly reactivated in highly immunocompromised patients. Viremia was documented in 36 (15 %) episodes investigated, including the detection of HHV6 (n=14), EBV (n=15), CMV (n=6), or HAdV (n=1). While low or intermediate levels of viremia (10 copies/ml) was documented in patients without evidence for other infections, raising the possibility that at least in some instances the onset of fever may have been attributable to the virus detected. The observations suggest that viral infections, potentially resulting from reactivation, might also play a clinically relevant role in patients receiving chemotherapy for treatment of malignant neoplasms, and routine screening for viremia in this clinical setting might be warranted. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.
About The Expert
Klára Obrová
Silke Grumaz
Marlene Remely
Stefan Czurda
Isabella Krickl
Susanne Herndlhofer
Karoline V Gleixner
Wolfgang R Sperr
Lisa Größlinger
Tijana Frank
Nuno Andrade
Teresa Egger-Matiqi
Christina Peters
Gernot Engstler
Michael Dworzak
Andishe Attarbaschi
Martine van Grotel
Marry M van den Heuvel-Eibrink
Ivan S Moiseev
Yuliya Rogacheva
Ludmilla Zubarovskaya
Natalia Zubarovskaya
Herbert Pichler
Anita Lawitschka
Elisabeth Koller
Felix Keil
Peter Valent
Kai Sohn
Thomas Lion
References
PubMed