2000
DOI: 10.1038/sj.bmt.1702118
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Respiratory syncytial virus immune globulin treatment of lower respiratory tract infection in pediatric patients undergoing bone marrow transplantation – a compassionate use experience

Abstract: Summary:Respiratory syncytial virus (RSV) pneumonia in BMT recipients carries a mortality rate of approximately 50-70% despite ribavirin (Virazole) treatment. In both immunocompetent and immunocompromised animal models, RSV neutralizing antibodies rapidly reduce pulmonary virus load after a single dose. RSV-IGIV (RespiGam) is an IgG immune globulin with high concentrations of RSV neutralizing antibody (Ͼ19 200 MU/ml). From June 1991 to February 1996, a compassionate-use protocol using RSV-IGIV for treatment of… Show more

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Cited by 112 publications
(66 citation statements)
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“…This patient died on the second day of ribavirin therapy. Similar results were reported by DeVincenzo et al 19 who treated 10 children with RSV pneumonia with RSV-IG (750-1500 mg/kg/dose) and aerosolized ribavirin. The one death in this latter series occurred in a patient with SCID who died 41 days following a mismatched parental transplant.…”
Section: Discussionsupporting
confidence: 79%
“…This patient died on the second day of ribavirin therapy. Similar results were reported by DeVincenzo et al 19 who treated 10 children with RSV pneumonia with RSV-IG (750-1500 mg/kg/dose) and aerosolized ribavirin. The one death in this latter series occurred in a patient with SCID who died 41 days following a mismatched parental transplant.…”
Section: Discussionsupporting
confidence: 79%
“…Recent attempts to treat stem cell transplant patients with severe RSV pneumonia have relied on regimens which combine large doses of RSVIG and aerosolized ribavirin. 8,9 Replacement of RSVIG with palivizumab could allow the delivery of large amounts of anti-RSV antibody activity, possibly through multiple repeat doses, without the significant fluid/protein challenge posed by large amounts of RSVIG. These studies suggest a role for palivizumab immunoprophylaxis and therapy in stem cell transplant patients.…”
Section: Discussionmentioning
confidence: 99%
“…16 The same author recently presented a series of pediatric BMT recipients who received combination ribavirin and RSVIG therapy for RSV pneumonia, which resulted in survival in 10 of 11 patients, a marked improvement compared with historical survival rates in similar patients. 17 In the cotton rat model, using cytotoxic immunosuppression comparable to that used in BMT regimens, we were able to establish a prolonged high-titer pulmonary RSV infection, which may in some ways parallel the disease seen in BMT recipients. Both prophylactic and therapeutic RSVIG, even in modest doses, were effective in reducing or eliminating viral replication in suppressed animals.…”
Section: Discussionmentioning
confidence: 84%