Respiratory syncytial virus infections in autologous blood and marrow transplant recipients with breast cancer: combination therapy with aerosolized ribavirin and parenteral immunoglobulins.
Scant data are available concerning the impact and response to therapy of respiratory syncytial virus (RSV) infections in patients undergoing autologous blood and marrow transplantation (BMT) for breast cancer. During eight winter seasons from 1992-1993 to 1999-2000, nine (4%) of 249 such patients were hospitalized with RSV infections. Six patients, including all five patients who were early post transplant in the pre-engraftment period, developed pneumonia and were treated with a combination of aerosolized ribavirin and IVIG. Among five patients with pneumonia in whom therapy was initiated prior to respiratory failure, one (20%) died. The sixth patient, in whom therapy was initiated after respiratory failure developed, also died. In total, two (1%) patients, both of whom were in the pre-engraftment period, died of progressive pneumonia. In conclusion, RSV is a significant cause of life-threatening pneumonia in autologous BMT recipients with breast cancer during the early post-transplant period, and accounted for a substantial portion of the overall transplant-related mortality, which in recent years has been minimal.
Ghosh
S
S
Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
Champlin
R E
RE
Ueno
N T
NT
Anderlini
P
P
Rolston
K
K
Raad
I
I
Kontoyiannis
D
D
Jacobson
K
K
Luna
M
M
Tarrand
J
J
Whimbey
E
E
D000336:Aerosols; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000633:toxicity; D000998:Antiviral Agents / Q000008:administration & dosage; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000401:mortality; D001943:Breast Neoplasms / Q000150:complications* / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D011024:Pneumonia, Viral / Q000139:chemically induced / Q000188:drug therapy / Q000401:mortality; D018357:Respiratory Syncytial Virus Infections / Q000139:chemically induced / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage; D015996:Survival Rate; D014182:Transplantation, Autologous / Q000009:adverse effects / Q000401:mortality
D000336:Aerosols; D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D012254:Ribavirin