DAS181 Treatment of Severe Parainfluenza Virus 3 Pneumonia in Allogeneic Hematopoietic Stem Cell Transplant Recipients Requiring Mechanical Ventilation

Table 1

Summary of cases of DAS181 treatment for PIV3 pneumonia in SCT recipients described in the literature.

	Case 1	Case 2	Case 3	Case 4	Case 5	Case 6	Case 7
Age (y)/sex	63/F	64/F	69/M	12/M	7 months/M	4/M	3/M
Underlying disease	AML	Unknown	MDS	Relapsed ALL	SCID	Stage 4 neuroblastoma	AML
Type of transplant	Reduced intensity Allogeneic HSCT from MUD	Nonmyeloablative; Allogeneic HSCT	Allogenic HSCT	Double cord	Single cord	Autologous HSCT	MUD peripheral blood HSCT
GVHD	Day 24	Chronic	Chronic	None	None	None	None
Immune suppression for GVHD	Corticosteroids; Mycophenolate; mofetil	Prednisone; Sirolimus	Prednisone	None	None	None	None
Onset of PIV
URTI	URTI: TxD + 89			URTI: TxD + 260	URTI: TxD + 71	URTI: TxD + 26	URTI: TxD + 2
LRTI	LRTI: TxD + 124	6 y SP SCT	LRTI: TxD + 240	LRTI: TxD + 275	LRTI: TxD + 2	LRTI: TxD + 25
Type of PIV	PIV3	PIV1	PIV3	PIV3	PIV2	PIV3	PIV3
Radiographic findings	Tree in bud opacities, mild diffuse bronchial thickening consistent with viral bronchiolitis on CT	Ground glass opacities on CT	Ground glass opacities on CT	Ground glass opacities on CXR/CT	Infiltrates on CXR/CT	New infiltrates on CXR/CT
Clinical symptoms	Cough, dyspnea, increased oxygen requirements	Respiratory distress, increased oxygen requirements	Fever, hemoptysis, and respiratory distress	Respiratory distress, increased oxygen requirements	Fever, wheezing, and increased oxygen requirements	Fever, cough, and crackles	Cough, rhinorrhea
Copathogens	Reactivated CMV viremia (prior to PIV URTI)	None	None	Adenovirus and hMPV (at time of URTI); HRV and Adenovirus (at time of LRTI)	None	None	HRV
Mechanical ventilation	None	Intubated	Intubated	None	None	None	None
DAS181 treatment	10 mg/day × 3 days (dry inhaled powder)	3.2 mg/day × 3 days (nebulized) and then 4.5 mg/day × 2 days (nebulized and face mask)	3.2 mg/day × 3 days and then 4.5 mg/day × 2 days (nebulized)	10 mg/day × 10 days (dry powder)	0.14 mg/kg per day × 2 days and then 0.2 mg/kg per day × 3 days (nebulized)	0.14 mg/kg per day × 2 days and then 0.2 mg/kg per day × 3 days (nebulized)	0.14 mg/kg per day × 10 days (nebulized)
Maximum alkaline phosphatase while on treatment, IU/L (normal range)	Not reported	240 (35–104)	169 (35–104)	477 (135–530)	298 (95–380)	598 (95–380)	247 (95–380)
Outcome	Died of relapsed AML	Died	Alive	Alive	Alive	Alive	Alive
Year/reference	2011 [11]	2014 [10]	2014 [10]	2015 [14]	2015 [14]	2015 [14]	2015 [14]

AML, acute myeloid leukemia; MDS, myelodysplastic syndrome; ALL, acute lymphoblastic leukemia; SCID, severe combined immunodeficiency; MURD, matched unrelated donor; URTI, upper respiratory tract infection; LRTI, lower respiratory tract infection; TxD, transplant day; CXR chest Xray; CT computerized tomography; CMV, cytomegalovirus; hMPV, human metapneumovirus; HRV, human rhinovirus.