Rhinovirus Infection Among Patients With Hematologic Malignancy at a Cancer Center. Issue 1 (January 2016) - Yacoub, Abraham Tareq
Abstract : Background: New research on rhinovirus (RV) has elevated the role of the virus as a significant contributor to respiratory complications in immunocompromised patients. Although RV has been implicated to cause morbidity and mortality in immunocompromised patients, its role has been difficult to characterize due to a limited availability of conventional diagnostics. Recent developments in polymerase chain reaction techniques have enabled better detection of RV and thus a means to better study its impact on immunocompromised patients. Materials and Methods: We performed a retrospective analysis of patients with hematologic malignancy at the Moffitt Cancer Center in Tampa, Fla, with a positive nasopharyngeal swab polymerase chain reaction for RV with symptomatic infection. The patients were identified based on the presence of hematologic malignancy, with or without a history of stem cell transplantation (SCT). The patient's clinical notes including age, SCT transplant date, symptoms, chest x-ray, chest computed tomography scan, cancer type, medications, and laboratory values were collected. Results: Among patients with RV infection, 97.5% (78/80) had a mild illness. Of those patients, all had resolution of symptoms by 30 days after the onset of symptoms. A total of 16.25% (13/80) had evidence of pneumonia on imaging studies, and a total of 56.25% (45/80) had evidence of lymphopenia versus only 28.75% (23/80) with evidence of neutropenia. The overall mortality was 2.5% (2/80) with both patients having evidence of coinfection with another pathogen at the time. Conclusions: Our study found that the overall mortality associated with RV was low but that coinfection was rarely associated with mortality. Rhinovirus infection is benign, and patients can proceed to transplant before they clear the virus. Cryptogenic organizing pneumonia may be a rare but serious complication after RV infection, especially after SCT. However, the main cause of morbidity and possible mortality is secondary infections with other viruses, bacteria, or molds.