Abstract
Community-acquired respiratory virus (CARV) infections have been recognized as a significant cause of morbidity and mortality in patients with leukemia and those undergoing hematopoietic stem cell transplantation (HSCT). Progression to lower respiratory tract infection with clinical and radiological signs of pneumonia and respiratory failure appears to depend on the intrinsic virulence of the specific CARV as well as factors specific to the patient, the underlying disease, and its treatment. To better define the current state of knowledge of CARVs in leukemia and HSCT patients, and to improve CARV diagnosis and management, a working group of the Fourth European Conference on Infections in Leukaemia (ECIL-4) 2011 reviewed the literature on CARVs, graded the available quality of evidence, and made recommendations according to the Infectious Diseases Society of America grading system. Owing to differences in screening, clinical presentation, and therapy for influenza and adenovirus, ECIL-4 recommendations are summarized for CARVs other than influenza and adenovirus.
Highlights
Community-acquired respiratory virus (CARV) infections include a variety of RNA viruses such as human orthymyxo, paramyxo, picorna, and coronaviruses, and DNA viruses such as adeno, boca, and polyomaviruses [1, 2]
PubMed was searched using each of the following terms: respiratory virus, respiratory syncytial virus, metapneumovirus, parainfluenza, rhinovirus, enterovirus, picornavirus, coronavirus, polyomavirus, bocavirus; together with leukemia, or hematopoietic transplantation, or hematopoietic stem cell transplantation (HSCT), or bone marrow transplantation, or cord blood
ECIL-4 Treatment Recommendations for CARV Infection Reflecting the clinical impact compared to other CARVs, the working group distinguishes the need of treatment for influenza A and B [10], Repiratory syncytial virus (RSV) and human parainfluenza virus (HPIV), taking into account the higher risk for poor outcome in specific patient groups
Summary
Fourth European Conference on Infections in Leukaemia (ECIL-4): Guidelines for Diagnosis and Treatment of Human Respiratory Syncytial Virus, Parainfluenza Virus, Metapneumovirus, Rhinovirus, and Coronavirus. To better define the current state of knowledge of CARVs in leukemia and HSCT patients, and to improve CARV diagnosis and management, a working group of the Fourth European Conference on Infections in Leukaemia (ECIL-4) 2011 reviewed the literature on CARVs, graded the available quality of evidence, and made recommendations according to the Infectious Diseases Society of America grading system. To better define the impact of CARVs in leukemia and HSCT patients, and to improve their diagnosis and management, a working group of the Fourth European Conference on Infections in Leukaemia (ECIL-4) 2011 reviewed the literature on CARVs, graded the available evidence, and made recommendations according to the Infectious Diseases Society of America grading system (Supplementary Table 1). Because several aspects regarding influenzavirus and adenovirus differ substantially, including availability of vaccines and use of specific antivirals, and screening of high-risk patients for occurrence of gastrointestinal and disseminated disease, respectively, ECIL recommendations are summarized for CARVs other than influenza and adenovirus [10]
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