Jp. Devincenzo et al., IMMUNOTHERAPY OF RESPIRATORY SYNCYTIAL VIRUS PNEUMONIA FOLLOWING BONE-MARROW TRANSPLANTATION, Bone marrow transplantation, 17(6), 1996, pp. 1051-1056
Respiratory syncytial virus (RSV) pneumonia is a well-recognized compl
ication of bone marrow transplantation with a high mortality rate. We
describe two patients who developed RSV pneumonia within the first 3 w
eeks following allogeneic bone marrow transplantation. These patients
had significant oxygen requirements and radiographic infiltrates. Both
were treated with aerosolized ribavirin and given a single 1.5 gm/kg
dose of intravenous immune globulin containing high levels of RSV neut
ralizing activity (RSV-IG). Both patients showed subjective and object
ive improvement after RSV-IG, never required mechanical ventilation, a
nd were discharged without an oxygen requirement within 2 weeks after
therapy. RSV microneutralization activity was measured in serum and na
sal secretions. Mean serum microneutralization activity increased from
2279 microneutralization units (Mu)/ml to 18 082 Mu/ml after RSV-IG.
Peak serum microneutralization activity achieved with RSV-IG was highe
r than that achieved in a series of other immunocompromised adults wit
h RSV pneumonia given either multiple doses of standard IVIG or no imm
une globulin therapy. RSV-IG may be beneficial in the treatment of RSV
pneumonia in severely immunocompromised patients.