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Blood, 1 March 2004, Vol. 103, No. 5, pp. 1611-1617. Prepublished online as a Blood First Edition Paper on October 2, 2003; DOI 10.1182/blood-2003-05-1425. This Article Full Text Full Text (PDF) All Versions of this Article: 2003-05-1425v1 103/5/1611    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Anaissie, E. J. Articles by Barlogie, B. Search for Related Content PubMed PubMed Citation Articles by Anaissie, E. J. Articles by Barlogie, B. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS The natural history of respiratory syncytial virus infection in cancer and transplant patients: implications for management Elias J. Anaissie, Tahsine H. Mahfouz, Turan Aslan, Anastasia Pouli, Rahman Desikan, Athanasios Fassas, and Bart Barlogie From the Myeloma Institute for Research & Therapy, University of Arkansas for Medical Sciences, Little Rock. Respiratory syncytial virus (RSV) has been reported to cause severe morbidity and mortality among cancer patients receiving chemotherapy with or without autologous peripheral blood stem cell transplantation (APBSCT). However, little is known about the natural history of this infection in these patients, and current standard practice, aerosolized ribavirin plus intravenous immunoglobulin (IVIG), is extremely expensive, difficult to use, and not supported by controlled clinical trials. The purpose of this observational study was to determine the frequency, seasonality, morbidity, and mortality of RSV infection in a group of cancer patients receiving cytotoxic chemotherapy with neither ribavirin nor IVIG treatment. During the period of October 3, 1997, through October 14, 1998, 190 cancer patients (median age, 58 years; 71 women) underwent viral nasopharyngeal washing prior to chemotherapy. Multiple myeloma (MM) accounted for most patients (147, 77%). RSV was recovered from cultures taken from 71 patients (37%) throughout the year, although more frequently during fall and winter seasons (P < .001) than spring and summer. Serious respiratory complications developed in 19 (27%) of 71 RSV-positive patients versus 24 (20%) of 119 patients whose RSV cultures were negative (P = .384). The presence of renal failure or increased lactate dehydrogenase (LDH) prior to chemotherapy and the development of mucositis were the only predictive factors for severe respiratory complications. Recovery of RSV from nasopharyngeal washings among cancer patients is common, occurs throughout the year, and does not appear to increase serious morbidity or mortality. RSV infection may not necessarily be a contraindication for APBSCT or an indication for therapy with aerosolized ribavirin and IVIG. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: C. M. El Saleeby, G. W. Somes, J. P. DeVincenzo, and A. H. Gaur Risk Factors for Severe Respiratory Syncytial Virus Disease in Children With Cancer: The Importance of Lymphopenia and Young Age Pediatrics, February 1, 2008; 121(2): 235 - 243. [Abstract] [Full Text] [PDF] H. A. Torres, E. A. Aguilera, G. N. Mattiuzzi, M. E. Cabanillas, N. Rohatgi, C. A. Sepulveda, H. M. Kantarjian, Y. Jiang, A. Safdar, I. I. Raad, et al. Characteristics and outcome of respiratory syncytial virus infection in patients with leukemia Haematologica, September 1, 2007; 92(9): 1216 - 1223. [Abstract] [Full Text] [PDF] A. J. Peck, J. A. Englund, J. Kuypers, K. A. Guthrie, L. Corey, R. Morrow, R. C. Hackman, A. Cent, and M. Boeckh Respiratory virus infection among hematopoietic cell transplant recipients: evidence for asymptomatic parainfluenza virus infection Blood, September 1, 2007; 110(5): 1681 - 1688. [Abstract] [Full Text] [PDF] L. Joos and M. Tamm Breakdown of Pulmonary Host Defense in the Immunocompromised Host: Cancer Chemotherapy Proceedings of the ATS, December 1, 2005; 2(5): 445 - 448. [Abstract] [Full Text] [PDF] J. R. Wingard, W. G. Nichols, and G. B. McDonald Supportive Care Hematology, January 1, 2004; 2004(1): 372 - 389. [Abstract] [Full Text] [PDF]

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