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Viral Infections

Successful ribavirin therapy for severe adenovirus hemorrhagic cystitis after allogeneic marrow transplant from close HLA donors rather than distant donors

Bone Marrow Transplantation volume 25, pages 545–548 (2000)Cite this article

Abstract

Intravenous ribavirin was given to nine patients who had developed severe adenovirus-induced hemorrhagic cystitis (AD-HC) which was resistant to conventional therapy or where there was involvement of other organs after allogeneic BMT. Three patients recovered completely from AD-HC, two of whom had been resistant to vidarabine. All three had received sibling BMTs (2 HLA matched, 1 HLA mismatched). Five patients who received BMTs from related (2 HLA mismatched) or unrelated (1 HLA matched, 2 HLA mismatched) showed an improvement in symptoms but had recurrent AD-HC after discontinuation of ribavirin. Improvement in clinical symptoms and termination of virus excretion were well correlated. The last patient who received a mismatched unrelated BMT died during ribavirin therapy. Ribavirin was notably more effective among patients receiving BMTs from siblings in contrast to patients receiving BMTs from alternative donors (<0.05). One patient experienced severe pancytopenia during the second treatment with ribavirin after hc recurrence and recovered after ceasing ribavirin. Thus, ribavirin seems to be very effective for severe ad-hc for some recipients who receive transplants from a genetically close donor. Bone Marrow Transplantation (2000) 25, 545–548.

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Acknowledgements

The authors are grateful to Miss Naoko Iwashima for the management of the import of ribavirin and Dr Gouji Kato, Makoto Hayashi and Yuko Kojima for patient information.

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Authors and Affiliations

  1. First Department of Internal Medicine, Nagoya University School of Medicine, Japan

    K Miyamura, A Kohno, M Tanimoto & H Saito

  2. Department of Internal Medicine, The Japanese Red Cross Nagoya First Hospital, Japan

    M Hamaguchi, H Taji, T Kanie & Y Kodera

  3. Department of Pediatrics, The Japanese Red Cross Nagoya First Hospital, Chiba, Japan

    S Kojima & T Matsuyama

  4. Department of Hematology, Meitetsu Hospital, Japan

    K Kitaori

  5. Department of Internal Medicine, Harasanshinn Hospital, Japan

    K Nagafuji

  6. Department of Pediatrics, Chiba University School of Medicine, Chiba, Japan

    T Sato

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  1. K Miyamura
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  2. M Hamaguchi
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Miyamura, K., Hamaguchi, M., Taji, H. et al. Successful ribavirin therapy for severe adenovirus hemorrhagic cystitis after allogeneic marrow transplant from close HLA donors rather than distant donors. Bone Marrow Transplant 25, 545–548 (2000). https://doi.org/10.1038/sj.bmt.1702195

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  • DOI: https://doi.org/10.1038/sj.bmt.1702195

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