Successful ribavirin therapy for severe adenovirus hemorrhagic cystitis after allogeneic marrow transplant from close HLA donors rather than distant donors

Bone Marrow Transplant. 2000 Mar;25(5):545-8. doi: 10.1038/sj.bmt.1702195.


Intravenous ribavirin was given to nine patients who had developed severe adenovirus-induced hemorrhagic cystitis (AD-HC) which was resistant to conventional therapy or where there was involvement of other organs after allogeneic BMT. Three patients recovered completely from AD-HC, two of whom had been resistant to vidarabine. All three had received sibling BMTs (2 HLA matched, 1 HLA mismatched). Five patients who received BMTs from related (2 HLA mismatched) or unrelated (1 HLA matched, 2 HLA mismatched) showed an improvement in symptoms but had recurrent AD-HC after discontinuation of ribavirin. Improvement in clinical symptoms and termination of virus excretion were well correlated. The last patient who received a mismatched unrelated BMT died during ribavirin therapy. Ribavirin was notably more effective among patients receiving BMTs from siblings in contrast to patients receiving BMTs from alternative donors (<0.05). One patient experienced severe pancytopenia during the second treatment with ribavirin after HC recurrence and recovered after ceasing ribavirin. Thus, ribavirin seems to be very effective for severe AD-HC for some recipients who receive transplants from a genetically close donor. Bone Marrow Transplantation (2000) 25, 545-548.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adenoviridae Infections / drug therapy*
  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Antiviral Agents / therapeutic use*
  • Antiviral Agents / toxicity
  • Bone Marrow Transplantation / adverse effects*
  • Child
  • Cystitis / drug therapy*
  • Cystitis / virology*
  • Female
  • Fever
  • HLA Antigens
  • Hematologic Neoplasms / complications
  • Hematologic Neoplasms / therapy
  • Hemorrhage / drug therapy
  • Hemorrhage / microbiology
  • Histocompatibility / immunology*
  • Humans
  • Male
  • Nuclear Family
  • Pancytopenia / chemically induced
  • Ribavirin / administration & dosage*
  • Ribavirin / toxicity
  • Survival Rate
  • Tissue Donors
  • Transplantation, Homologous / adverse effects


  • Antiviral Agents
  • HLA Antigens
  • Ribavirin