An outbreak of respiratory syncytial virus infection in a bone marrow transplant unit: effect on engraftment and outcome of pneumonia without specific antiviral treatment
Immunocompromised haematological patients are at high risk for severe, often fatal, respiratory syncytial virus (RSV) pneumonia. In the 2001 winter season, 16 of 195 (8.2%) adult haematological in-patients were diagnosed with RSV infection. Eight patients had undergone stem cell transplantation. The...
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| creator | ABDALLAH, A ROWLAND, K. E SCHEPETIUK, S. K TO, L. B BARDY, P |
| description | Immunocompromised haematological patients are at high risk for severe, often fatal, respiratory syncytial virus (RSV) pneumonia. In the 2001 winter season, 16 of 195 (8.2%) adult haematological in-patients were diagnosed with RSV infection. Eight patients had undergone stem cell transplantation. The median age was 53 years (range 20-67). A total of 11 patients had nosocomial RSV infection while the rest (five) had community-acquired infection. All patients were febrile and had upper respiratory tract infection (URTI). Eight patients (50%) developed lower RTI. Two of the 16 patients (12.5%) died of respiratory failure, due to the RSV pneumonia, despite ICU admission and supportive ventilation. None of the studied patients received ribavirin therapy or specific RSV immunoglobulin. Two patients autografted for multiple myeloma (MM) showed delayed neutrophil and platelet engraftment despite receiving an adequate dose of stem cells. A third patient undergoing a CD34+ selected HLA-matched sibling mini-allograft for relapsed MM showed graft failure shortly after RSV infection. In our series, RSV infection was concurrent with an outbreak in the community. Unlike other published series, no specific antiviral treatment for RSV pneumonia was used and yet the overall outcome in our patients was favourable. Furthermore, RSV infection in the pre-engraftment period after autologous transplantation was associated with delayed engraftment. |
| doi_str_mv | 10.1038/sj.bmt.1704116 |
| format | Article |
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Two patients autografted for multiple myeloma (MM) showed delayed neutrophil and platelet engraftment despite receiving an adequate dose of stem cells. A third patient undergoing a CD34+ selected HLA-matched sibling mini-allograft for relapsed MM showed graft failure shortly after RSV infection. In our series, RSV infection was concurrent with an outbreak in the community. Unlike other published series, no specific antiviral treatment for RSV pneumonia was used and yet the overall outcome in our patients was favourable. Furthermore, RSV infection in the pre-engraftment period after autologous transplantation was associated with delayed engraftment.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/sj.bmt.1704116</identifier><identifier>PMID: 12838285</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>Basingstoke: Nature Publishing Group</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Antiviral agents ; Antiviral Agents - therapeutic use ; Autografts ; Biological and medical sciences ; Bone marrow ; Bone marrow transplantation ; Bone Marrow Transplantation - adverse effects ; Bone marrow, stem cells transplantation. Graft versus host reaction ; CD34 antigen ; Community-Acquired Infections ; Cross Infection ; Disease Outbreaks ; Dosage and administration ; Drug therapy ; Fatalities ; Female ; Graft rejection ; Graft Survival ; Hematologic Diseases - complications ; Hematologic Diseases - therapy ; Hematology ; Histocompatibility antigen HLA ; Hospital Units ; Humans ; Immunosuppression - adverse effects ; Infections ; Leukocytes (neutrophilic) ; Male ; Mechanical ventilation ; Medical sciences ; Middle Aged ; Multiple myeloma ; Nosocomial infection ; Outbreaks ; Patients ; Physiological aspects ; Pneumonia ; Pneumonia, Viral - etiology ; Respiratory failure ; Respiratory syncytial virus ; Respiratory Syncytial Virus Infections - etiology ; Respiratory Syncytial Virus Infections - therapy ; Respiratory Syncytial Virus Infections - transmission ; Respiratory tract ; Respiratory tract diseases ; Ribavirin ; Risk factors ; Stem cell transplantation ; Stem cells ; Transfusions. Complications. 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E</creatorcontrib><creatorcontrib>SCHEPETIUK, S. K</creatorcontrib><creatorcontrib>TO, L. B</creatorcontrib><creatorcontrib>BARDY, P</creatorcontrib><title>An outbreak of respiratory syncytial virus infection in a bone marrow transplant unit: effect on engraftment and outcome of pneumonia without specific antiviral treatment</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><description>Immunocompromised haematological patients are at high risk for severe, often fatal, respiratory syncytial virus (RSV) pneumonia. In the 2001 winter season, 16 of 195 (8.2%) adult haematological in-patients were diagnosed with RSV infection. Eight patients had undergone stem cell transplantation. The median age was 53 years (range 20-67). A total of 11 patients had nosocomial RSV infection while the rest (five) had community-acquired infection. All patients were febrile and had upper respiratory tract infection (URTI). Eight patients (50%) developed lower RTI. Two of the 16 patients (12.5%) died of respiratory failure, due to the RSV pneumonia, despite ICU admission and supportive ventilation. None of the studied patients received ribavirin therapy or specific RSV immunoglobulin. Two patients autografted for multiple myeloma (MM) showed delayed neutrophil and platelet engraftment despite receiving an adequate dose of stem cells. A third patient undergoing a CD34+ selected HLA-matched sibling mini-allograft for relapsed MM showed graft failure shortly after RSV infection. In our series, RSV infection was concurrent with an outbreak in the community. Unlike other published series, no specific antiviral treatment for RSV pneumonia was used and yet the overall outcome in our patients was favourable. Furthermore, RSV infection in the pre-engraftment period after autologous transplantation was associated with delayed engraftment.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Antiviral agents</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Autografts</subject><subject>Biological and medical sciences</subject><subject>Bone marrow</subject><subject>Bone marrow transplantation</subject><subject>Bone Marrow Transplantation - adverse effects</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>CD34 antigen</subject><subject>Community-Acquired Infections</subject><subject>Cross Infection</subject><subject>Disease Outbreaks</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Fatalities</subject><subject>Female</subject><subject>Graft rejection</subject><subject>Graft Survival</subject><subject>Hematologic Diseases - complications</subject><subject>Hematologic Diseases - therapy</subject><subject>Hematology</subject><subject>Histocompatibility antigen HLA</subject><subject>Hospital Units</subject><subject>Humans</subject><subject>Immunosuppression - adverse effects</subject><subject>Infections</subject><subject>Leukocytes (neutrophilic)</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multiple myeloma</subject><subject>Nosocomial infection</subject><subject>Outbreaks</subject><subject>Patients</subject><subject>Physiological aspects</subject><subject>Pneumonia</subject><subject>Pneumonia, Viral - etiology</subject><subject>Respiratory failure</subject><subject>Respiratory syncytial virus</subject><subject>Respiratory Syncytial Virus Infections - etiology</subject><subject>Respiratory Syncytial Virus Infections - therapy</subject><subject>Respiratory Syncytial Virus Infections - transmission</subject><subject>Respiratory tract</subject><subject>Respiratory tract diseases</subject><subject>Ribavirin</subject><subject>Risk factors</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Transfusions. 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Graft versus host reaction</topic><topic>CD34 antigen</topic><topic>Community-Acquired Infections</topic><topic>Cross Infection</topic><topic>Disease Outbreaks</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Fatalities</topic><topic>Female</topic><topic>Graft rejection</topic><topic>Graft Survival</topic><topic>Hematologic Diseases - complications</topic><topic>Hematologic Diseases - therapy</topic><topic>Hematology</topic><topic>Histocompatibility antigen HLA</topic><topic>Hospital Units</topic><topic>Humans</topic><topic>Immunosuppression - adverse effects</topic><topic>Infections</topic><topic>Leukocytes (neutrophilic)</topic><topic>Male</topic><topic>Mechanical ventilation</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multiple myeloma</topic><topic>Nosocomial infection</topic><topic>Outbreaks</topic><topic>Patients</topic><topic>Physiological aspects</topic><topic>Pneumonia</topic><topic>Pneumonia, Viral - etiology</topic><topic>Respiratory failure</topic><topic>Respiratory syncytial virus</topic><topic>Respiratory Syncytial Virus Infections - etiology</topic><topic>Respiratory Syncytial Virus Infections - therapy</topic><topic>Respiratory Syncytial Virus Infections - transmission</topic><topic>Respiratory tract</topic><topic>Respiratory tract diseases</topic><topic>Ribavirin</topic><topic>Risk factors</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>Transfusions. 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E</au><au>SCHEPETIUK, S. K</au><au>TO, L. B</au><au>BARDY, P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An outbreak of respiratory syncytial virus infection in a bone marrow transplant unit: effect on engraftment and outcome of pneumonia without specific antiviral treatment</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><addtitle>Bone Marrow Transplant</addtitle><date>2003-07-01</date><risdate>2003</risdate><volume>32</volume><issue>2</issue><spage>195</spage><epage>203</epage><pages>195-203</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><coden>BMTRE9</coden><abstract>Immunocompromised haematological patients are at high risk for severe, often fatal, respiratory syncytial virus (RSV) pneumonia. In the 2001 winter season, 16 of 195 (8.2%) adult haematological in-patients were diagnosed with RSV infection. Eight patients had undergone stem cell transplantation. The median age was 53 years (range 20-67). A total of 11 patients had nosocomial RSV infection while the rest (five) had community-acquired infection. All patients were febrile and had upper respiratory tract infection (URTI). Eight patients (50%) developed lower RTI. Two of the 16 patients (12.5%) died of respiratory failure, due to the RSV pneumonia, despite ICU admission and supportive ventilation. None of the studied patients received ribavirin therapy or specific RSV immunoglobulin. Two patients autografted for multiple myeloma (MM) showed delayed neutrophil and platelet engraftment despite receiving an adequate dose of stem cells. A third patient undergoing a CD34+ selected HLA-matched sibling mini-allograft for relapsed MM showed graft failure shortly after RSV infection. In our series, RSV infection was concurrent with an outbreak in the community. Unlike other published series, no specific antiviral treatment for RSV pneumonia was used and yet the overall outcome in our patients was favourable. Furthermore, RSV infection in the pre-engraftment period after autologous transplantation was associated with delayed engraftment.</abstract><cop>Basingstoke</cop><pub>Nature Publishing Group</pub><pmid>12838285</pmid><doi>10.1038/sj.bmt.1704116</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Bone marrow transplantation (Basingstoke), 2003-07, Vol.32 (2), p.195-203 |
| issn | 0268-3369 1476-5365 |
| language | eng |
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| source | MEDLINE; Nature; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Antiviral agents Antiviral Agents - therapeutic use Autografts Biological and medical sciences Bone marrow Bone marrow transplantation Bone Marrow Transplantation - adverse effects Bone marrow, stem cells transplantation. Graft versus host reaction CD34 antigen Community-Acquired Infections Cross Infection Disease Outbreaks Dosage and administration Drug therapy Fatalities Female Graft rejection Graft Survival Hematologic Diseases - complications Hematologic Diseases - therapy Hematology Histocompatibility antigen HLA Hospital Units Humans Immunosuppression - adverse effects Infections Leukocytes (neutrophilic) Male Mechanical ventilation Medical sciences Middle Aged Multiple myeloma Nosocomial infection Outbreaks Patients Physiological aspects Pneumonia Pneumonia, Viral - etiology Respiratory failure Respiratory syncytial virus Respiratory Syncytial Virus Infections - etiology Respiratory Syncytial Virus Infections - therapy Respiratory Syncytial Virus Infections - transmission Respiratory tract Respiratory tract diseases Ribavirin Risk factors Stem cell transplantation Stem cells Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation Transplants & implants Treatment Outcome Virus diseases Viruses |
| title | An outbreak of respiratory syncytial virus infection in a bone marrow transplant unit: effect on engraftment and outcome of pneumonia without specific antiviral treatment |
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