Intravenous hyperimmune globulin prophylaxis against cytomegalovirus interstitial pneumonitis after allogenic bone marrow transplantation

Abstract

In an attempt to reduce the incidence of lethal cytomegalovirus (CMV) interstitial pneumonitis after allogenic bone marrow transplantation 49 patients were randomized in a multicenter controlled study to receive either CMV-hyperimmune globulin or a control immune globulin with low anticytomegalovirus titer. Immune globulin was administered intravenously 6 times with 20 days interval, starting on day 7 before transplantation. Patients receiving CMV hyperimmune globulin or control immune globulin were comparable with regard to age, diagnosis, pretransplant anti-CMV titer, incidence of graft-versus-host disease and transfusions. In each group, the incidence of histologically proven CMV interstitial pneumonitis during the first 110 days post BMT was recorded. Six of 23 patients in the control group versus 1 of 26 in the CMV hyperimmune globulin group died of CMV interstitial pneumonitis (p less than 0.05). No significant effect on idiopathic pneumonitis or survival was observed.