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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
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.
AuthorsJ P DeVincenzo, R L Hirsch, R J Fuentes, F H Top Jr
JournalBone marrow transplantation (Bone Marrow Transplant) Vol. 25 Issue 2 Pg. 161-5 (Jan 2000) ISSN: 0268-3369 [Print] England
PMID10673674 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)
Chemical References
  • Antibodies, Viral
  • Antiviral Agents
  • Immunoglobulins, Intravenous
  • respiratory syncytial virus immune globulin intravenous
  • Ribavirin
Topics
  • Administration, Inhalation
  • Adult
  • Antibodies, Viral (blood)
  • Antiviral Agents (administration & dosage, therapeutic use)
  • Bone Marrow Transplantation (adverse effects, immunology)
  • Child
  • Child, Preschool
  • Clinical Protocols
  • Combined Modality Therapy
  • Humans
  • Immunoglobulins, Intravenous (administration & dosage, adverse effects, immunology, therapeutic use)
  • Immunosuppression Therapy (adverse effects)
  • Infant
  • Neutralization Tests
  • Pneumonia, Viral (immunology, therapy)
  • Respiratory Syncytial Virus Infections (immunology, therapy)
  • Respiratory Syncytial Viruses (immunology, physiology)
  • Ribavirin (administration & dosage, therapeutic use)
  • Survival Rate
  • Viral Load

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