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| |  ASBMT: Respiratory Syncytial Virus Infections Following Allogeneic Hematopoietic Stem Cell Transplant May Predispose Patients to Pulmonary Complications By Norma Alonzo KEYSTONE, CO -- February 16, 2005 -- Respiratory syncytial virus infections in pediatric patients who have undergone allogeneic hematopoietic stem cell transplant (HSCT) may result in persistent and significant residual lung injury, predisposing them to potentially fatal, postinfectious pulmonary complications or chronic lung disease, say researchers. Any allogeneic patient with respiratory symptoms should be aggressively evaluated for presence of lower airway disease, presence of a community respiratory virus, and with microbiologic assays for rapid and specific diagnosis, reported investigators at the 2005 Tandem Bone and Marrow Transplant Meeting on February 13th. The researchers further stated, "Any early allogeneic BMT [bone marrow transplantation] patient, or those at high risk for invasive viral disease, should be considered for aggressive, early treatment if it is available." Ralph R. Quinones, MD, associate professor at the University of Colorado School of Medicine and the Children's Hospital in Denver, Colorado, and colleagues conducted a retrospective analysis of 128 allogeneic HSCT patients to identify those who had developed RSV and to analyze the consequence of subsequent pulmonary complications. Thirty-seven of the 128 patients (29%) were diagnosed with RSV. While 33 of 37 patients survived and cleared the infection, 12 of 16 patients who eradicated the virus with therapy died due to subsequent pulmonary complications. In follow-up of patients 1484 days after transplantation, the researchers found that 18 of 21 patients who had survived the RSV infection posttransplantation had subsequent pulmonary complications, including immune-mediated lung disease. Eight of the 21 patients developed chronic lung disease, primarily reactive air disease or asthma. "Interventions to modify the immunologic response to respiratory viral infection should be prospectively evaluated in allogeneic BMT recipients to attempt to decrease the morbidity and mortality from subsequent immune-mediated lung disease," concluded the investigators.
[Presentation title: Respiratory Syncytial Virus Infections in Allogeneic HSCT Patients: Effective Antiviral Therapy Eliminates Acute Mortality, But Infection-Related Lung Injury May Predispose to Subsequent Pulmonary Complications. Abstract 278]
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