Severe respiratory syncytial virus pulmonary infection in a patient treated with fludarabine for chronic lymphocytic leukemia.
Fludarabine phosphate is currently proposed for the treatment of refractory chronic lymphocytic leukemia (CLL). CD4 T-lymphocyte depletion, myelosuppression, and subsequent severe infections are the major side effects of fludarabine phosphate therapy. We report here on a heretofore undescribed respiratory syncytial virus (RSV) infection in a patient with a long-standing history of refractory CLL that was treated with fludarabine phosphate. The patient developed a severe infection of the upper and lower respiratory tract with bilateral pulmonary infiltrates and severe hypoxemia. RSV was the only infectious agent that could be isolated, and treatment with aerosolized ribavirin lead to prompt improvement of all symptoms.
Service d'Immuno-Hématologie, Hôpital Saint-Louis, Paris, France.
P
P
Eftekhari
K
K
Lassoued
E
E
Oksenhendler
C
C
Scieux
J P
JP
Clauvel
D000280:Administration, Inhalation; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000188:drug therapy*; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy / Q000209:etiology*; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use; D014740:Vidarabine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D000998:Antiviral Agents; D012254:Ribavirin; D014740:Vidarabine; C024352:fludarabine