Respiratory syncytial virus in hematopoietic cell transplant recipients and patients with hematologic malignancies

Khawaja, Fareed; Chemaly, Roy F.

Community respiratory viruses are a common cause of respiratory infections. [1] [2] [3] These viruses are perhaps best known for their seasonal variation. The outcomes of these infections vary on the basis of the patient population, with adverse outcomes having been described in hematopoietic cell transplant (HCT) recipients and patients with a hematologic malignancy (HM). [4] [5] [6] [7] [8] [9] One of the most common community respiratory viruses that may lead to the death of HCT recipients and HM patients is respiratory syncytial virus (RSV), 4-10 whose incidence is second only to that of influenza according to prior reports; 4, 5, 8, 11, 12 other viruses include parainfluenza virus, metapneumovirus, adenovirus, rhinovirus, and bocavirus. Different strategies have been used for the management of RSV infections in immunocompromised patients, and HCT recipients in particular, including ribavirin in its different formulations, intravenous immunoglobulins (IVIG), RSV immunoglobulins, and RSV monoclonal antibodies. 6 In addition, effective measures have been used to curtail outbreaks of RSV infection in numerous bone marrow transplantation units and oncology wards, with some success; [13] [14] [15] [16] [17] [18] [19] however, despite some advances over the past two decades in early detection and management of RSV infections in immunocompromised patients, the outcomes related to these infections remain poor.