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 r espiratory syncytial virus (RSV) infections in patients undergoing autologo us blood and marrow transplantation (BMT) for breast cancer. During eight w inter seasons from 1992-1993 to 1999-2000, nine (4%) of 249 such patients w ere hospitalized with RSV infections. Six patients, including all five pati ents who were early post transplant in the pre-engraftment period, develope d pneumonia and were treated with a combination of aerosolized ribavirin an d IVIG. Among five patients with pneumonia in whom therapy was initiated pr ior to respiratory failure, one (20%) died. The sixth patient, in whom ther apy was initiated after respiratory failure developed, also died. In total, two (1 %) patients, both of whom were in the preengraftment period, died o f progressive pneumonia. In conclusion, RSV is a significant cause of life- threatening pneumonia in autologous BMT recipients with breast cancer durin g the early post-transplant period, and accounted for a substantial portion of the overall transplant-related mortality, which in recent years has bee n minimal.