PHASE-I STUDY OF INTRAVENOUS RIBAVIRIN TREATMENT OF RESPIRATORY SYNCYTIAL VIRUS PNEUMONIA AFTER MARROW TRANSPLANTATION

Respiratory syncytial virus (RSV) pneumonia in marrow transplant recip ients is associated with significant mortality, Ribavirin is a nucleos ide analog with activity against RSV and in its aerosolized formulatio n is the only drug approved for treatment of RSV pneumonia in the Unit ed States, The clinical use of aerosolized ribavirin has been limited by caregivers' concerns about drug exposure and potential teratogenic effects, Since there is lack of proven efficacy and safety of the aero solized ribavirin in this setting, we performed a phase I study of int ravenous ribavirin treatment, Between November 1993 and May 1993, 10 p atients with clinically significant RSV pneumonia at the Fred Hutchins on Cancer Research Center were enrolled, Only 2 of the 10 survived (20 %; 95% CI, 3-56), Two of the 10 patients developed acute hemolysis tha t necessitated discontinuation of the medication, In conclusion, treat ment of marrow transplant recipients with RSV pneumonia with intraveno us ribavirin did not improve mortality compared with historical contro ls treated with the aerosolized drug.