Authors
Latefah Aleshaiwi, Afrah Alotaibi, Mohsen Alzahrani, Mohammad Bosaeed, Hajar AlQahtani, Abdulellah Almohaya
Published in
IDCases. Volume 45. Pages e02721. Epub Aug 08, 2026.
Abstract
Respiratory syncytial virus (RSV) is associated with significant morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients, particularly during the peri-transplant period. Therapeutic options remain limited, and the role of adjunctive RSV-specific immunotherapy is unclear. We evaluated the outcomes of palivizumab combined with ribavirin in high-risk adult HSCT recipients with RSV infection.
We retrospectively reviewed adult HSCT recipients with RT-PCR-confirmed RSV infection who received palivizumab and ribavirin. Clinical characteristics, treatment timing, outcomes, adverse events, and mortality were assessed.
Three adult allogeneic HSCT recipients who developed RSV infection between (day - 4 to day +2) were identified. Two patients survived, who had moderate- to high-risk disease according to the Immunodeficiency Scoring Index (ISI-RSV), while one patient with high-risk disease developed progressive respiratory failure and died despite intensive therapy, likely due to concomitant mucormycosis. No treatment-related adverse events were observed. Earlier initiation of ribavirin and palivuzumab, and the intravenous route of palivuzumab, were observed in the two cases who achieved complete recovery.
Adjunctive palivizumab appears to be safe and may be a useful therapeutic option for HSCT recipients with RSV infection during the peri-transplant period. Larger prospective studies are needed to define the optimal role, timing, and route of palivizumab administration in this high-risk population.
PMID:
42633199
Bibliographic data and abstract were imported from PubMed on 23 Aug 2026.
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