Upper and/or Lower Respiratory Tract Infection Caused by Human Metapneumovirus After Allogeneic Hematopoietic Stem Cell Transplantation

Jose Luis Piñana*, Gloria Tridello, The Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation and Infectious Complications Subcommittee of the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC), Aliénor Xhaard, Lotus Wendel, Juan Montoro, Lourdes Vazquez, Inmaculada Heras, Per Ljungman, Malgorzata Mikulska, Urpu Salmenniemi, Ariadna Perez, Nicolaus Kröger, Jan Cornelissen, Elisa Sala, Rodrigo Martino, Claire Geurten, Jenny Byrne, Johan Maertens, Tessa KerreMurray Martin, Maria Jesús Pascual, Moshe Yeshurun, Jürgen Finke, Andreas H. Groll, Peter J. Shaw, Nicole Blijlevens, William Arcese, Arnold Ganser, Maria Suarez-Lledo, Mohsen Alzahrani, Goda Choi, Edouard Forcade, Annalisa Paviglianiti, Carlos Solano, Jacek Wachowiak, Tsila Zuckerman, Peter Bader, Johannes Clausen, Jiri Mayer, Wilfried Schroyens, Elisabetta Metafuni, Nina Knelange, Dina Averbuch, Rafael De La Camara

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)


Background: Human metapneumovirus (hMPV) epidemiology, clinical characteristics and risk factors for poor outcome after allogeneic stem cell transplantation (allo-HCT) remain a poorly investigated area. Methods: This retrospective multicenter cohort study examined the epidemiology, clinical characteristics, and risk factors for poor outcomes associated with human metapneumovirus (hMPV) infections in recipients of allo-HCT. Results: We included 428 allo-HCT recipients who developed 438 hMPV infection episodes between January 2012 and January 2019. Most recipients were adults (93%). hMPV infections were diagnosed at a median of 373 days after allo-HCT. The infections were categorized as upper respiratory tract disease (URTD) or lower respiratory tract disease (LRTD), with 60% and 40% of cases, respectively. Patients with hMPV LRTD experienced the infection earlier in the transplant course and had higher rates of lymphopenia, neutropenia, corticosteroid use, and ribavirin therapy. Multivariate analysis identified lymphopenia and corticosteroid use (>30 mg/d) as independent risk factors for LRTD occurrence. The overall mortality at day 30 after hMPV detection was 2% for URTD, 12% for possible LRTD, and 21% for proven LRTD. Lymphopenia was the only independent risk factor associated with day 30 mortality in LRTD cases. Conclusions: These findings highlight the significance of lymphopenia and corticosteroid use in the development and severity of hMPV infections after allo-HCT, with lymphopenia being a predictor of higher mortality in LRTD cases.

Original languageEnglish
Pages (from-to)83-94
Number of pages12
JournalJournal of Infectious Diseases
Issue number1
Publication statusPublished - 15 Jan 2024

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© 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved.


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