Respiratory Syncytial Virus Infection in Recipients of Allogeneic Stem-Cell Transplantation: A Retrospective Study of the Incidence, Clinical Features, and Outcome

Avetisyan, Gayane; Mattsson, Jonas; Sparrelid, E.; Ljungman, Per

doi:10.1097/tp.0b013e3181bb477e

Cited by 87 publications

(92 citation statements)

References 22 publications

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“…In lung transplant patients, lower respiratory tract infections (LRTIs) with RSV can be a risk factor for bronchiolitis obliterans (23,24) and death in up to 20% of cases (20). RSV infection in allogeneic stem cell transplant patients leads to LRTI that is associated with an increased risk of death in up to 70% of those infected (21,25). In pediatric transplant patients, not all infections are disastrous and outcomes vary broadly from uneventful resolution to hospital admission, with a smaller subset admitted to the intensive care unit (ICU) (22).…”

Section: Overall Impact: Mortality and Health Care Costsmentioning

confidence: 99%

Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment

2017

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SUMMARY Respiratory syncytial virus (RSV) infection is a significant cause of hospitalization of children in North America and one of the leading causes of death of infants less than 1 year of age worldwide, second only to malaria. Despite its global impact on human health, there are relatively few therapeutic options available to prevent or treat RSV infection. Paradoxically, there is a very large volume of information that is constantly being refined on RSV replication, the mechanisms of RSV-induced pathology, and community transmission. Compounding the burden of acute RSV infections is the exacerbation of preexisting chronic airway diseases and the chronic sequelae of RSV infection. A mechanistic link is even starting to emerge between asthma and those who suffer severe RSV infection early in childhood. In this article, we discuss developments in the understanding of RSV replication, pathogenesis, diagnostics, and therapeutics. We attempt to reconcile the large body of information on RSV and why after many clinical trials there is still no efficacious RSV vaccine and few therapeutics.

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Section: Overall Impact: Mortality and Health Care Costsmentioning

confidence: 99%

Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment

2017

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“…Eight of the studies did not meet all the inclusion criteria. 5,8,15,18,53,[61][62][63] In 3 other studies, 19,64,65 more than one form of ribavirin was used, but data on outcome measures for each form were not available separately. The data from these 3 studies were not looked at individually but were included and analyzed only as part of the total number of patients treated versus untreated (Table 4).…”

Section: Therapeutic Outcomesmentioning

confidence: 99%

“…The use of intravenous or oral ribavirin with or without immunomodulator(s) has been reported from few centers, mainly in Europe. 4,10,19,20,25,57,60,64,65 Intravenous ribavirin may be a good therapeutic option when lung consolidation may prevent penetration or absorption of the aerosolized drug. Intravenous ribavirin has been shown to be well tolerated in HSCT patients.…”

Section: Table 3 Studies That Reported the Usage Of Intravenous And/mentioning

confidence: 99%

Management of RSV infections in adult recipients of hematopoietic stem cell transplantation

Shah

Chemaly

2011

Blood

231

255

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“…5,6 Morbidity and mortality rates reported in the literature are heterogeneous, the relevance of RSV infections in terms of outcome for patients undergoing autologous or allogeneic SCT ranging from none 7,8 to a mortality rate of up to 78%. [9][10][11][12][13][14] The impact of RSV on fatal outcome in this often multimorbid patient population might be difficult, if not impossible, to assess. Aerosolized ribavirin is the only Food and Drug Administration-approved drug for the treatment of severe RSV infection in children.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and containment of respiratory syncytial virus outbreak in a hematology and transplant unit

Lehners

Schnitzler

Geis

et al. 2013

Bone Marrow Transplant

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Respiratory syncytial virus (RSV) usually causes self-limiting upper respiratory tract infections, but can be associated with severe lower respiratory tract infection disease (LRTID) in infants and in patients with hematologic malignancies. We have analyzed the risk factors and the measures for containment within an outbreak of nosocomial RSV infections in a hematology and SCT unit. A total of 56 patients were affected (53 RSV-A and 3 RSV-B) including 32 transplant patients (16 allogeneic and 16 autologous). Forty (71%) of the 56 patients suffered from LRTID and 14 (35%) of the patients with LRTID subsequently died. However, because of concomitant infections with fungal and bacterial pathogens, the impact of RSV on the fatal outcome was difficult to assess. Multivariate analysis showed that low levels of IgG were significantly associated with fatal outcome (P ¼ 0.007), treatment with oral ribavirin represented a protective factor (P ¼ 0.02). An extremely protracted viral shedding was observed in this cohort of patients (median ¼ 30.5 days, range: 1-162 days), especially pronounced in patients after allogeneic transplantation (P ¼ 0.002). Implementation of rigorous isolation and barrier measures, although challenged by long-term viral carriers, was effective in containment of the outbreak.

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Respiratory Syncytial Virus Infection in Recipients of Allogeneic Stem-Cell Transplantation: A Retrospective Study of the Incidence, Clinical Features, and Outcome

Abstract: RSV infection results in a low overall attributable mortality after allo-HSCT, but progression of the infection to LRTI is associated with increased risk for death. Late respiratory dysfunction is more common among patients, experienced RSV infection compared with controls.

Cited by 87 publications

References 22 publications

Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment

Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment

Management of RSV infections in adult recipients of hematopoietic stem cell transplantation

Risk factors and containment of respiratory syncytial virus outbreak in a hematology and transplant unit

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