Successful ribavirin therapy for severe adenovirus hemorrhagic cystitis after allogeneic marrow transplant from close HLA donors rather than distant donors

Intravenous ribavirin was given to nine patients who had developed severe a denovirus-induced hemorrhagic cystitis (AD-HC) which was resistant to conve ntional therapy or where there was involvement of other organs after alloge neic BMT, Three patients recovered completely from AD-HC, two of whom had b een resistant to vidarabine, All three had received sibling BMTs (2 HLA mat ched, 1 HLA mismatched). Five patients who received BMTs from related (2 HL A mismatched) or unrelated (1 HLA matched, 2 HLA mismatched) showed an impr ovement in symptoms but had recurrent AD-HC after discontinuation of ribavi rin, Improvement in clinical symptoms and termination of virus excretion we re well correlated. The last patient who received a mismatched unrelated BM T died during ribavirin therapy. Ribavirin was notably more effective among patients receiving BMTs from siblings in contrast to patients receiving BM Ts from alternative donors (<0.05). One patient experienced severe pancytop enia during the second treatment with ribavirin after HC recurrence and rec overed after ceasing ribavirin, Thus, ribavirin seems to be very effective for severe AD-HC for some recipients who receive transplants from a genetic ally close donor.