Respiratory viral infections after bone marrow/peripheral stem-cell transplantation: the Christie hospital experience1

Hassan, Ibrahim A.; Chopra, Rajesh; Swindell, Richard; Mutton, Kenneth J.

doi:10.1038/sj.bmt.1704048

Cited by 101 publications

(66 citation statements)

References 20 publications

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“…[1][2][3][4]8,12,[14][15][16][17][18][19][20][21] Furthermore, the development of LRTI has been consistently associated with significantly higher risk of death. 12,13,17,18 Early intervention with antiviral therapy has been demonstrated to reduce the risk of progression to pneumonia 7 and may lead to improved survival.…”

Section: Discussionmentioning

confidence: 99%

Oral ribavirin for treatment of respiratory syncitial virus and parainfluenza 3 virus infections post allogeneic haematopoietic stem cell transplantation

Casey

Morris

Narayana

et al. 2013

Bone Marrow Transplant

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The prognosis for patients with respiratory syncytial virus (RSV) or parainfluenza virus type 3 (PIV3) respiratory tract infection post allogeneic haematopoietic progenitor cell transplant (HPCT) is historically poor. The use of oral ribavirin (RBV) has not been widely studied in this patient population. We examined the outcomes of 15 consecutive patients (RSV, n ¼ 13 and PIV3, n ¼ 2) treated with oral RBV post HPCT. Oral RBV was commenced at a starting dose of 10 mg/kg/day, increasing to a maximum dose of 60 mg/kg/day depending on response and tolerance. At diagnosis, seven patients had upper respiratory tract infection (URTI) and eight had lower respiratory tract infection (LRTI). The starting RBV dose of 10 mg/kg/day did not prevent the progression of URTI to LRTI in any patient. However, with dose escalation, six of the seven patients responded to RBV therapy and survived their infective episode. Of the eight patients presenting with LRTI, six patients survived their infection, again after dose escalation of RBV. There was no dose-limiting toxicity seen in any patient. Our results indicate that oral RBV has clinical efficacy in the treatment of RSV/PIV3 infection post HPCT. However, a starting dose of 10 mg/kg/day appears ineffective; we recommend a starting dose of 20 mg/kg/day in this patient group.

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Section: Discussionmentioning

confidence: 99%

Oral ribavirin for treatment of respiratory syncitial virus and parainfluenza 3 virus infections post allogeneic haematopoietic stem cell transplantation

Casey

Morris

Narayana

et al. 2013

Bone Marrow Transplant

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“…The potential burden of RSV reinfection of adults on the health care system has been underappreciated; RSV also causes significant disease in healthy adults (especially those with contact with children) and generally passes undiagnosed (63). RSV causes high morbidity and mortality in patients with underlying cardiopulmonary illnesses (178), the elderly (44), and the immunosuppressed, particularly bone marrow transplant patients (68,135).…”

Section: The Burden Of Rsv Disease Epidemiology and Clinical Presentamentioning

confidence: 99%

Immune Responses and Disease Enhancement during Respiratory Syncytial Virus Infection

2005

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Respiratory syncytial virus (RSV) is one of the commonest and most troublesome viruses of infancy. It causes most cases of bronchiolitis, which is associated with wheezing in later childhood. In primary infection, the peak of disease typically coincides with the development of specific T- and B-cell responses, which seem, in large part, to be responsible for disease. Animal models clearly show that a range of immune responses can enhance disease severity, particularly after vaccination with formalin-inactivated RSV. Prior immune sensitization leads to exuberant chemokine production, an excessive cellular influx, and an overabundance of cytokines during RSV challenge. Under different circumstances, specific mediators and T-cell subsets and antibody-antigen immune complex deposition are incriminated as major factors in disease. Animal models of immune enhancement permit a deep understanding of the role of specific immune responses in RSV disease, assist in vaccine design, and indicate which immunomodulatory therapy might be beneficial to children with bronchiolitis

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“…The development of vancomycinresistant Enterococcus and methicillin-resistant Staphylococcus aureus is a reminder of the potentially devastating consequences of bacterial infections. Furthermore, fungal and viral infections are increasingly a major problem in haematology patients and now represent a major cause of morbidity and mortality (Chopra, 2002;Hassan et al, 2003).…”

Section: Justification For Granulocyte Transfusionsmentioning

confidence: 99%

The role of granulocyte transfusions in neutropenic patients

Bishton

Chopra

2004

Br J Haematol

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Respiratory viral infections after bone marrow/peripheral stem-cell transplantation: the Christie hospital experience1

Cited by 101 publications

References 20 publications

Oral ribavirin for treatment of respiratory syncitial virus and parainfluenza 3 virus infections post allogeneic haematopoietic stem cell transplantation

Oral ribavirin for treatment of respiratory syncitial virus and parainfluenza 3 virus infections post allogeneic haematopoietic stem cell transplantation

Immune Responses and Disease Enhancement during Respiratory Syncytial Virus Infection

The role of granulocyte transfusions in neutropenic patients

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