Infección por adenovirus en receptores pediátricos de trasplante de progenitores hematopoyéticos

Adenovirus infection in pediatric hematopoietic stem cell transplant recipients.

Publicado 2025-06-27

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Brito Moreno JA, Calderon Gasca A. Infección por adenovirus en receptores pediátricos de trasplante de progenitores hematopoyéticos. Rev. colomb. hematol. oncol. [Internet]. 2025 Jun. 27 [cited 2025 Dec. 5];12(1):240-54. https://doi.org/10.51643/22562915.707

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Vol. 12 Núm. 1 (2025): Enero-Junio
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Brito Moreno JA, Calderon Gasca A. Infección por adenovirus en receptores pediátricos de trasplante de progenitores hematopoyéticos. Rev. colomb. hematol. oncol. [Internet]. 2025 Jun. 27 [cited 2025 Dec. 5];12(1):240-54. https://doi.org/10.51643/22562915.707
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Javier Alexander Brito Moreno
Clínica del Country, Bogotá, Colombia
Roles:  
https://orcid.org/0009-0008-9911-8514
Alejandra Calderon Gasca
Fundación Santa Fe de Bogotá image/svg+xml
Roles:  
https://orcid.org/0000-0002-5594-0185
Mostrar biografía de los autores

Javier Alexander Brito Moreno,

 Médico, Hematooncólogo Pediatra.

Alejandra Calderon Gasca ,

Médica, Especialista en Pediatría, Especialista en Hemato oncología pediátrica, Maestría en Trasplante de Progenitores Hematopoyético e Inmunoterapia, Maestría en Oncología Neurológica.

Introducción: la infección por adenovirus se produce entre el 14-16 % de los pacientes en los primeros tres a cuatro meses tras un trasplante alogénico de progenitores hematopoyéticos (TPH), siendo más frecuente en la población pediátrica que en adultos. Esto se correlaciona con mayor riesgo de desarrollar enfermedades por adenovirus y mortalidad global a los seis meses. La prevención de la enfermedad por adenovirus se basa en la identificación temprana de la replicación vírica en sangre o heces y la intervención. El cidofovir, un análogo del nucleótido monofosfato de citosina, es actualmente el único antiviral recomendado para la infección por adenovirus. Métodos: se realizó una revisión sistemática sobre la infección por adenovirus en receptores de trasplante de células hematopoyéticas. Los estudios seleccionados fueron revisados a texto completo. Se extrajo información clave como tipo de estudio, población, diagnóstico, tratamiento y desenlaces clínicos. Los resultados se presentaron de forma narrativa por la heterogeneidad entre los estudios. Resultados: en pacientes pediátricos con trasplante, se recomienda tamizaje fecal antes y después del procedimiento. El tratamiento incluye reducción de inmunosupresión, cidofovir o brincidofovir. La inmunoterapia con linfocitos T específicos es prometedora, aunque limitada por acceso y tiempo de producción. La vigilancia temprana mejora el pronóstico. Conclusión: la infección por adenovirus en TPH requiere diagnóstico y tamizaje oportunos, con tratamiento antiviral e inmunoterapia adoptiva. En Colombia estas terapias no están disponibles, por lo que debemos visibilizar su importancia para mejorar el manejo de estos pacientes inmunosuprimidos.

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