Risk factors for severe respiratory syncytial virus disease in children with cancer: The importance of lymphopenia and young age
Risk factors for severe respiratory syncytial virus disease in children with cancer: The importance of lymphopenia and young age
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DOI：
10.1542/peds.2007-1102
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发表时间：
2008-02-01
期刊：
影响因子：
8
通讯作者：
Gaur, Aditya H.
中科院分区：
文献类型：
--
作者：
El Saleeby, Chadi M.;Somes, Grant W.;Gaur, Aditya H.
OBJECTIVE.我们试图确定呼吸道合胞病毒感染免疫功能低下的儿科患者的流行病学特征，并确定严重疾病的危险因素。我们设计了一项回顾性研究，检查1997年至2005年期间患有基础恶性肿瘤和造血干细胞移植受者的儿科患者呼吸道合胞病毒感染的经验。临床和实验室数据从患者记录中提取，并对疾病严重程度的独立预测因素进行了研究。58例患者符合研究标准。23例患者（40%）有急性淋巴细胞白血病的基础诊断，11例（19%）有实体瘤，24例（41%）是造血干细胞移植受者，患有急性髓细胞白血病或重度联合免疫缺陷综合征。17例患者（29%）年龄< 2岁。总体而言，16例患者（28%）发生下呼吸道感染。造血干细胞移植、急性髓性白血病或严重联合免疫缺陷综合征患者下呼吸道感染的频率最高（42%）。下呼吸道感染的独立预测因素是严重的淋巴细胞减少症，淋巴细胞绝对计数< 100个细胞/mm（3），
OBJECTIVE. We sought to determine the epidemiologic features of respiratory syncytial virus infection in immunocompromised pediatric patients and to identify the risk factors for severe disease.METHODS. We designed a retrospective study examining the experience with respiratory syncytial virus infection in pediatric patients with underlying malignancies and hematopoietic stem cell transplant recipients seen between 1997 and 2005. Clinical and laboratory data were extracted from patient records, and independent predictors of disease severity were investigated.RESULTS. Fifty-eight patients met the study criteria. Twenty-three patients (40%) had underlying diagnoses of acute lymphoblastic leukemia, 11 (19%) had solid tumors, and 24 (41%) were hematopoietic stem cell transplant recipients, had acute myeloid leukemia, or had severe combined immunodeficiency syndrome. Seventeen patients (29%) were < 2 years of age. Overall, 16 patients (28%) developed lower respiratory tract infections. The frequency of lower respiratory tract infections was highest in patients with hematopoietic stem cell transplants, acute myeloid leukemia, or severe combined immunodeficiency syndrome (42%). Independent predictors of lower respiratory tract infections were profound lymphopenia, with absolute lymphocyte counts of < 100 cells per mm(3), and age of