Intravenous immunoglobulin for modification of cytomegalovirus infections associated with bone marrow transplantation. Preliminary results of a controlled trial.

The effects of immune globulin intravenous, 5 percent in 10 percent maltose, on cytomegalovirus infection and interstitial pneumonia in bone marrow transplants were evaluated in a randomized controlled trial. Eighteen patients were given weekly doses (20 cc/kg) of intravenous immunoglobulin before and after transplantation, and 18 patients were controls. The incidence of cytomegalovirus infection was similar in the control and intravenous immunoglobulin-treated groups, but symptomatic cytomegalovirus infection (eight of 18 versus three of 18, p = 0.14) and interstitial pneumonia (10 of 18 versus four of 18, p = 0.08) occurred less frequently in the group receiving intravenous immunoglobulin. Cytomegalovirus pneumonia developed in eight control patients and in three patients receiving intravenous immunoglobulin (p = 0.14), whereas two control patients and one patient receiving intravenous immunoglobulin experienced idiopathic interstitial pneumonia. These preliminary results suggest that intravenous immunoglobulin can modify the severity of cytomegalovirus infection and prevent interstitial pneumonia in bone marrow transplant recipients.