A new registry study reveals human metapneumovirus causes severe illness in blood cancer patients worldwide.
Human Metapneumovirus: An Emerging Threat in Hematological Malignancy
Human metapneumovirus (hMPV) is a respiratory pathogen that has long existed in the shadow of better-known viruses such as influenza and SARS-CoV-2. For patients with hematological malignancies, however, new data from a large multinational registry analysis suggest that hMPV deserves far greater clinical attention. The study, drawing on data from the EPICOVIDEHA/EPIRESEHA registry, examined outcomes in 130 patients with hematological malignancy who tested positive for hMPV between January 2023 and December 2024.
The patient cohort had a median age of 58.5 years, with 57% male. The most common underlying hematological diagnoses were plasma cell neoplasms (25%), lymphoma (23%), and acute myeloid leukemia (20%). The clinical course proved serious: 64% of patients required hospitalization, 19% were admitted to the intensive care unit (ICU), and the 30-day mortality rate reached 8%. Secondary infections complicated the course in nearly a quarter of patients (24%).
Comparable Severity to Influenza and SARS-CoV-2, Yet Fewer Targeted Treatments
One of the most striking findings was that hMPV produced clinical outcomes broadly comparable to those of influenza and SARS-CoV-2 in this population, yet patients with hMPV received significantly fewer targeted therapeutic interventions. ICU admission rates were 18.5% for hMPV versus 25.9% for influenza and 20.9% versus 4.7% for SARS-CoV-2. Thirty-day mortality was 5.6% for hMPV compared with 11.1% for influenza and 7.0% versus 2.3% for SARS-CoV-2. Despite this severity, 73% of hMPV patients received only supportive care, reflecting the absence of approved antiviral therapies or vaccines for this pathogen.
The analysis also identified chronic renal disease as a significant independent predictor of mortality in hMPV-infected patients with hematological malignancy, with a hazard ratio of 20.9 (P = .014). This finding underscores the need for clinicians to exercise heightened vigilance in patients who carry this comorbidity alongside an underlying blood cancer diagnosis.
Call for Greater Clinical Awareness and Investment
The authors conclude that human metapneumovirus remains an underrecognized and underdiagnosed pathogen in immunocompromised patients with hematological malignancy. In the absence of specific treatments or preventive vaccines, enhanced clinical awareness, improved diagnostic protocols, and investment in hMPV-targeted therapeutics are urgently needed to reduce the burden of this virus in this vulnerable population.
Reference
Salmanton-García J et al. Underrated, Unvaccinated, Untreated: A Multinational Registry Analysis of Human Metapneumovirus in Hematological Malignancy, Insights From EPICOVIDEHA/EPIRESEHA Registry. Open Forum Infect Dis. 2026;13(3):ofag099.
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