De Vincenzo J P, Leombruno D, Soiffer R J, Siber G R
Divisions of Infectious Diseases, Dana Farber Cancer Institute, Boston, MA, USA.
Bone Marrow Transplant. 1996 Jun;17(6):1051-6.
Respiratory syncytial virus (RSV) pneumonia is a well-recognized complication of bone marrow transplantation with a high mortality rate. We describe two patients who developed RSV pneumonia within the first 3 weeks following allogeneic bone marrow transplantation. These patients had significant oxygen requirements and radiographic infiltrates. Both were treated with aerosolized ribavirin and given a single 1.5 gm/kg dose of intravenous immune globulin containing high levels of RSV neutralizing activity (RSV-IG). Both patients showed subjective and objective improvement after RSV-IG, never required mechanical ventilation, and were discharged without an oxygen requirement within 2 weeks after therapy. RSV microneutralization activity was measured in serum and nasal secretions. Mean serum microneutralization activity increased from 2279 microneutralization units (Mu)/ml to 18082 Mu/ml after RSV-IG. Peak serum microneutralization activity achieved with RSV-IG was higher than that achieved in a series of other immunocompromised adults with RSV pneumonia given either multiple doses of standard IVIG or no immune globulin therapy. RSV-IG may be beneficial in the treatment of RSV pneumonia in severely immunocompromised patients.
呼吸道合胞病毒（RSV）肺炎是骨髓移植一种公认的并发症，死亡率很高。我们描述了两名在异基因骨髓移植后的前三周内发生RSV肺炎的患者。这些患者有显著的吸氧需求和影像学浸润。两人均接受了雾化利巴韦林治疗，并给予单次1.5克/千克剂量的含有高水平RSV中和活性的静脉免疫球蛋白（RSV-IG）。两名患者在接受RSV-IG治疗后均有主观和客观改善，从未需要机械通气，且在治疗后2周内无需吸氧即可出院。对血清和鼻分泌物进行了RSV微量中和活性检测。RSV-IG治疗后，血清平均微量中和活性从2279微量中和单位（Mu）/毫升增至18082 Mu/毫升。RSV-IG达到的血清微量中和活性峰值高于一系列其他患有RSV肺炎的免疫功能低下成人，这些成人接受了多剂量标准静脉注射免疫球蛋白或未接受免疫球蛋白治疗。RSV-IG可能对治疗严重免疫功能低下患者的RSV肺炎有益。
