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

Abstract

In the USA and other western nations, respiratory syncytial virus is one of the most commonly encountered respiratory viruses among patients who have been diagnosed with a hematologic malignancy or who have undergone a stem cell transplant. Multiple studies have been performed to evaluate the complications associated with respiratory syncytial virus infections. Other studies have evaluated therapeutic agents and strategies in which these agents can be used. There have also been numerous reports of outbreaks in bone marrow transplant units and oncology wards, where infection control measures have been invaluable in controlling the spread of disease. However, despite these novel approaches, respiratory syncytial virus continues to be potentially fatal in immunocompromised populations. In this review, we discuss the incidence of respiratory syncytial viral infections, risk factors associated with progression from upper respiratory tract infection to lower respiratory tract infection, other complications and outcomes (including mortality), management strategies, and prevention strategies in patients with a hematologic malignancy and in hematopoietic cell transplant recipients.

Figure 1.

Proposed treatment algorithm for respiratory syncytial virus infections in allogeneic hematopoietic cell transplant recipients. HCT: hematopoietic cell transplant; RSV: respiratory syncytial virus; CT: computed tomography; LRTI: lower respiratory tract infection; URTI: upper respiratory tract infection; ISI: Immunodeficiency Scoring Index; IVIG: intravenous immunoglobulins.