{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:39:15Z","timestamp":1789756755356,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adenovirus infection (AdVi) causes significant morbidity and mortality in allogeneic hematopoietic stem cell transplantation (allo\u2010HCT) recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study of 131 patients (2020\u20132024) compared systematic monitoring in high\u2010risk patients versus symptom\u2010based testing in standard\u2010risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 1\u2010year incidence of AdV DNAemia was 19.8%, with AdV disease at 5.3%, being higher in the routine monitoring cohort (26%) than in the symptom\u2010based cohort (11%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.031). Neither infection nor monitoring strategy impacted outcomes. The machine learning model identified predictive factors for early AdV DNAemia: age (50\u201365 years), diagnosis of acute leukemia or myelodysplastic syndrome, transplant from an HLA\u2010matched unrelated or haploidentical donor, and non\u2010myeloablative conditioning. Cost\u2010effectiveness analysis showed that risk\u2010based testing was optimal (\u20ac149 per additional detected case), while universal monitoring was excessively costly (\u20ac1006 per additional detected case).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion, although AdVi was common, routine monitoring did not improve outcomes and was financially burdensome, suggesting that a machine learning\u2010driven risk\u2010based testing strategy enhances cost\u2010effectiveness while ensuring timely AdV detection and intervention.<\/jats:p>\n                  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