Adenovirus infection after pediatric bone marrow transplantation

Retrospective analysis of 206 patients undergoing 215 consecutive bone marr ow transplants (BMT) at St Jude Children's Research Hospital between Novemb er 1990 and December 1994 identified 6% (seven male, six female) with adeno virus infection. The affected patients had a median age of 7.9 years (range 3-24 years) at time of transplantation. Although transplants were performe d for hematologic malignancies, solid tumors or nonmalignant conditions, on ly patients with hematologic malignancies had adenoviral infections. Adenov irus was first detected at a median of 54 days (range -4 to +333) after BMT , Adenovirus developed in eight of 69 (11.6%) patients receiving grafts fro m matched unrelated or mismatched related donors, in four of 52 (7.7%) rece iving grafts from HLA-matched siblings, and in one of 93 (1.1%) receiving a utografts, The most common manifestation of adenovirus infection was hemorr hagic cystitis, followed by gastroenteritis, pneumonitis and liver failure. The incidence of adenovirus infection in pediatric BMT patients at our ins titution is similar to that reported in adult patients. Using univariate an alysis, use of total body irradiation and type of bone marrow graft were si gnificant risk factors for adenovirus infection, Only use of total body irr adiation remained as a factor on multiple logistic regression analysis.