title: Successful ribavirin therapy for severe adenovirus hemorrhagic cystitis after allogeneic marrow transplant from close HLA donors rather than distant donors.
abstract: Intravenous ribavirin was given to nine patients who had developed severe adenovirus-induced hemorrhagic cystitis (AD-HC) which was resistant to conventional therapy or where there was involvement of other organs after allogeneic BMT. Three patients recovered completely from AD-HC, two of whom had been resistant to vidarabine. All three had received sibling BMTs (2 HLA matched, 1 HLA mismatched). Five patients who received BMTs from related (2 HLA mismatched) or unrelated (1 HLA matched, 2 HLA mismatched) showed an improvement in symptoms but had recurrent AD-HC after discontinuation of ribavirin. Improvement in clinical symptoms and termination of virus excretion were well correlated. The last patient who received a mismatched unrelated BMT died during ribavirin therapy. Ribavirin was notably more effective among patients receiving BMTs from siblings in contrast to patients receiving BMTs from alternative donors (<0.05). One patient experienced severe pancytopenia during the second treatment with ribavirin after HC recurrence and recovered after ceasing ribavirin. Thus, ribavirin seems to be very effective for severe AD-HC for some recipients who receive transplants from a genetically close donor. Bone Marrow Transplantation (2000) 25, 545-548.
authors.affiliation: First Department of Internal Medicine, Nagoya University School of Medicine, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Miyamura
authors.forename: M
authors.initials: M
authors.lastname: Hamaguchi
authors.forename: H
authors.initials: H
authors.lastname: Taji
authors.forename: T
authors.initials: T
authors.lastname: Kanie
authors.forename: A
authors.initials: A
authors.lastname: Kohno
authors.forename: M
authors.initials: M
authors.lastname: Tanimoto
authors.forename: H
authors.initials: H
authors.lastname: Saito
authors.forename: S
authors.initials: S
authors.lastname: Kojima
authors.forename: T
authors.initials: T
authors.lastname: Matsuyama
authors.forename: K
authors.initials: K
authors.lastname: Kitaori
authors.forename: K
authors.initials: K
authors.lastname: Nagafuji
authors.forename: T
authors.initials: T
authors.lastname: Sato
authors.forename: Y
authors.initials: Y
authors.lastname: Kodera
mesh_terms: D000257:Adenoviridae Infections / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use* / Q000633:toxicity; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D003556:Cystitis / Q000188:drug therapy* / Q000821:virology*; D005260:Female; D005334:Fever; D006680:HLA Antigens; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D006470:Hemorrhage / Q000188:drug therapy / Q000382:microbiology; D006648:Histocompatibility / Q000276:immunology*; D006801:Humans; D008297:Male; D009679:Nuclear Family; D010198:Pancytopenia / Q000139:chemically induced; D012254:Ribavirin / Q000008:administration & dosage* / Q000633:toxicity; D015996:Survival Rate; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000009:adverse effects
chemical_list: D000998:Antiviral Agents; D006680:HLA Antigens; D012254:Ribavirin