Infectious complications after hematopoietic stem cell transplantation: current status and future perspectives in Korea

Cho, Sung-Yeon; Lee, Hyeon-Jeong; Lee, Dong-Gun

Because some CRV-URTIs do not progress to LRTI and therapeutic agents are limited, it is important to identify CRV-URTI patients at increased risk of LRTI [129, 137, 140] . Treatment of RSV-URTI with aerosolized ribavirin significantly reduces the frequency of progression to LRTI (25% vs. 47%) [128] . In addition, the following immunodeficiency scoring index has been proposed: neutropenia (< 500 cells/mm 3 , 3 points), lymphopenia (< 200 cells/mm 3 , 3 points), age ≥ 40 years (2 points), myeloablative conditioning (1 point), GVHD (acute/chronic, 1 point), corticosteroids (1 point), and pre-engraftment or within 30 days of transplant (1 point). A score of > 7 is associated with a significantly increased risk of progression to LRTI, suggesting the necessity of criteria for identifying high-risk groups [141] . Palivizumab, a humanized anti-RSV monoclonal antibody, does not reduce the progression to LRTI in HSCT patients and is currently recommended only for prophylactic usage in high-risk children [142] . The risk factors for progression to LRTI have been discussed for PIV, human metapneumovirus, and rhinovirus URTIs, but treatment is not recommended because of a lack of evidence [129, 137, 140] .