Use of Cytomegalovirus Intravenous Immune Globulin for the Adjunctive Treatment of Cytomegalovirus in Hematopoietic Stem Cell Transplant Recipients

Study Objective. To describe the characteristics and clinical outcomes of hematopoietic stem cell transplant (HSCT) recipients who received adjunctive cytomegalovirus intravenous immune globulin (CMV‐IVIG) for probable or proven CMV disease. Design. Retrospective cohort study. Setting. Large, university‐affiliated, tertiary‐care medical center. Patients. Thirty‐five adult HSCT recipients who received at least one dose of CMV‐IVIG for adjunctive treatment of probable or proven CMV disease between January 1, 1999, and December 31, 2007. Measurements and Main Results. All‐cause mortality at hospital discharge was the primary outcome. All patients received an allogeneic HSCT. Twenty‐six patients (74%) had pneumonitis, nine (26%) had enteritis, and 29 (83%) had CMV viremia. All patients received concomitant antiviral therapy; 31 (89%) received ganciclovir, and 14 (40%) received foscarnet. All‐cause mortality at hospital discharge was 49% (17 patients). Patient characteristics associated with mortality included requiring intubation for CMV pneumonia (11 [79%] of 14 nonsurvivors vs 3 (25%) of 12 survivors, p=0.016) and earlier disease onset after HSCT (median 48 days for nonsurvivors vs 106 days for survivors, p