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Viral Infections

An outbreak of respiratory syncytial virus infection in a bone marrow transplant unit: effect on engraftment and outcome of pneumonia without specific antiviral treatment

Bone Marrow Transplantation volume 32, pages 195–203 (2003)Cite this article

Summary:

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.

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Acknowledgements

We thank Dr Matthias Maiwald, Department of Microbiology and Immunology, Stanford University, CA, USA, for reviewing this article.

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Authors and Affiliations

  1. Department of Clinical Haematology and Bone Marrow Transplantation Unit, Royal Adelaide Hospital, Adelaide, Australia

    A Abdallah, L B To & P Bardy

  2. Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, Australia

    K E Rowland

  3. Infectious Diseases Laboratories, Institute of Medical and Veterinary Science (IMVS), Adelaide, Australia

    S K Schepetiuk

  4. Division of Haematology, Institute of Medical and Veterinary Science (IMVS), Adelaide, Australia

    L B To & P Bardy

  5. Departments of Pathology and Medicine, University of Adelaide, Adelaide, Australia

    L B To

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Abdallah, A., Rowland, K., Schepetiuk, S. et al. An outbreak of respiratory syncytial virus infection in a bone marrow transplant unit: effect on engraftment and outcome of pneumonia without specific antiviral treatment. Bone Marrow Transplant 32, 195–203 (2003). https://doi.org/10.1038/sj.bmt.1704116

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