Molecular monitoring of adenovirus in peripheral blood after allogeneic bone marrow transplantation permits early diagnosis of disseminated disease

Evaluation of a surveillance strategy for early detection of adenovirus by PCR of peripheral blood in hematopoietic SCT recipients: incidence and outcome

“…Subsequently, newfound awareness of AdV may have led to more intense surveillance strategies reinforced by the application of new sensitive methods for molecular diagnosis. Several risk factors for AdV infection have been identified with different levels of effect on incidence: younger age, 5,[23][24][25] usage of T cell-depleted grafts, 13,26,27 grafts from an unrelated donor, 23 GVHD or its therapy 28 and a slow lymphocyte recovery. 13,27 In particular, transplantation of CD34 þ selected grafts were related to an increased incidence of AdV infection.…”

“…Our study would not support routine AdV screening in an unselected population of patients undergoing HSCT. However, taking results from other large prospective studies 13,26,30 into consideration, together with the practical and economical aspects of the sampling and laboratory work, we are not dismissing the idea of AdV screening. Detection of AdV DNA in peripheral blood and especially rapid increase in the viral load is associated with progression to disseminated AdV disease.…”

“…Detection of AdV DNA in peripheral blood and especially rapid increase in the viral load is associated with progression to disseminated AdV disease. 9,11,26,31 It would therefore be logical to identify what group of patients to screen and in what period after HSCT. As adults seem to get their AdV infection later in the post transplantation period, and the risk for AdV disease seems to be low, 25 a sampling schedule parallel to CMV screening may not be adequate.…”

Adenovirus Fulminant Hepatic Failure: Disseminated Adenovirus Disease after Unrelated Allogeneic Stem Cell Transplantation for Acute Lymphoblastic Leukemia

“…Therapeutic options for ADV disseminated disease are still very limited (1,7,10,36,38,39,41,43,(45)(46)(47). Intravenous or aerosolized ribavirin (1,7,19,38,45,47), vidarabine (7), and cidofovir (7,36,(45)(46)(47) are included in antiviral agents, and the intravenous administration of immunoglobulin (12), the discontinuation of antibiotics (36), donor lymphocyte infusion (7) (38).…”

Surveillance for adenovirus DNAemia early after transplantation in adult recipients of unrelated-donor allogeneic stem cell transplants in the absence of clinically suspected infection

“…1 Detection of AdV DNA in peripheral blood may precede by several days or weeks the diagnosis of clinically overt AdV disease. [1][2][3] In this context, sustained high-level or increasing AdV DNAemia appear to be specific and sensitive markers of progression of AdV infection to disseminated disease, both in pediatric and adult recipients. 3 Thus, early detection of AdV DNAemia may allow timely implementation of antiviral therapy and/or prompt tapering of immunosuppression, which may potentially minimize the risk of occurrence of disseminated infection.…”