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Viral Infections

Respiratory syncytial virus immune globulin treatment of lower respiratory tract infection in pediatric patients undergoing bone marrow transplantation – a compassionate use experience

Bone Marrow Transplantation volume 25, pages 161–165 (2000)Cite this article

Abstract

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 (>19 200 MU/ml). From June 1991 to February 1996, a compassionate-use protocol using RSV-IGIV for treatment of RSV infections was conducted. Eleven children at multiple centers, mean age 3.3 years (4 months to 9 years), were undergoing BMT and met the protocol criteria. They received a single 1500 mg/kg dose of RSV-IGIV infused over 12 h at a median of 5 days (1–37 days) after RSV symptom onset. Ten of these patients received prior or concurrent aerosolized ribavirin. Serum RSV neutralizing titers were measured in five patients and showed a 3- to 30-fold increase 24 h after RSV-IGIV infusion. Adverse events were mild. One of 11 (9.1%) patients died from their RSV illness (91% RSV survival). In comparison to previously published reports, RSV-IGIV treatment of RSV pneumonia in BMT patients may increase survival above that in such patients treated with ribavirin alone. Bone Marrow Transplantation (2000) 25, 161–165.

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Acknowledgements

We wish to especially thank Joni Love, RN in the Clinical Development Department of MedImmune, Inc. (Gaithersburg, MD) for her assistance in reviewing each patient record.

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Authors and Affiliations

  1. University of Tennessee, Memphis, TN, USA

    JP DeVincenzo

  2. LeBonheur Children's Hospital, Memphis, TN, USA

    JP DeVincenzo

  3. MedImmune Inc, Gaithersburg, MD, USA

    RL Hirsch, RJ Fuentes & FH Top Jr

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  1. JP DeVincenzo
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  2. RL Hirsch
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  4. FH Top Jr
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DeVincenzo, J., Hirsch, R., Fuentes, R. et al. Respiratory syncytial virus immune globulin treatment of lower respiratory tract infection in pediatric patients undergoing bone marrow transplantation – a compassionate use experience. Bone Marrow Transplant 25, 161–165 (2000). https://doi.org/10.1038/sj.bmt.1702118

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