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Viral infections in severely immunocompromised cancer patients

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Abstract

Immunocompromised cancer patients are susceptible to infection by many viral pathogens. The most serious morbidity results from active infection by members of the herpes virus family. Reactivation of latent virus occurs as a sequela of cytotoxic therapy and deficiency of cell-mediated immunity, especially cytotoxic responses, the major host protective defense. Herpes simplex virus and varicella zoster virus infections are problematic in patients with all types of cancer; cytomegalovirus infections cause life-threatening morbidity in bone marrow transplant patients. Several antiviral agents are highly active against these pathogens and different strategies of using them have resulted in reduced morbidity and mortality. Ultimately, the resolution of these infections is dependent on the control of the malignancy and the ability of the patient to mount an adequate immune response.

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References

  1. Akashi K, Eizura Y, Sumiyoshi Y, et al (1993) Brief report: severe infectious mononucleosis-like syndrome and primary human herpesvirus 6 infection in an adult. N Engl J Med 329:168–171

    Google Scholar 

  2. Ambinder RF, Burns W, Forman M, et al (1986) Hemorrhagic cystitis associated with adenovirus infection in bone marrow transplantation. Arch Intern Med 146:1400–1401

    Google Scholar 

  3. Arthur RR, Shah KV, Baust SJ, Santos GW, Saral R (1986) Association of BK viruria with hemorrhagic cystitis in recipients of bone marrow transplants. N Engl J Med 315:230–234

    Google Scholar 

  4. Aschan J, Ringdén O, Ljungman P, Lönnqvist B, Ohlman S (1992) Foscarnet for treatment of cytomegalovirus infections in bone marrow transplant recipients. Scand J Infect Dis 24:143–150

    Google Scholar 

  5. Atkinson K, Meyers JD, Storb R, Prentice RL, Thomas ED (1980) Varicella-zoster virus infection after marrow transplantation for aplastic anemia or leukemia. Transplantation 29:47

    Google Scholar 

  6. Balfour HH Jr, Bean B, Laskin OL, et al, and the Burroughs Wellcome Collaborative Acyclovir Study Group (1983) Acyclovir halts progression of herpes zoster in immunocompromised patients. N Engl J Med 308:1448–1453

    Google Scholar 

  7. Bass EB, Powe NR, Graziano SL, et al (1993) Efficacy of intravenous immune globulin in preventing complications of bone marrow transplantation: a meta analysis. Bone Marrow Transplant 12:273–282

    Google Scholar 

  8. Blanche S, Le Deist F, Veber F, et al (1988) Treatment of severe Epstein-Barr virus-induced polyclonal B-lymphocyte proliferation by anti-B-cell monoclonal antibodies: two cases after HLA-mismatched bone marrow transplantation. Ann Intern Med 108:199–203

    Google Scholar 

  9. Boeckh M, Bowden RA, Goodrich JM, Pettinger M, Meyers JD (1992) Cytomegalovirus antigen detection in peripheral blood leukocytes after allogeneic marrow transplantation. Blood 80:1358–1364

    Google Scholar 

  10. Boström L, Ringden O, Sundberg B, Linde A, Tollemar J, Nilsson B (1988) Pretransplant herpesvirus serology and acute graft-versus-host disease. Transplantation 46:548–552

    Google Scholar 

  11. Bowden RA, Sayers MH, Cays M, Slichter SJ (1989) The role of blood product filtration in the prevention of transfusion-associated cytomegalus (CMV) infection after marrow transplant. Transfusion 29:5205

    Google Scholar 

  12. Bowden RA, Slichter SJ, Sayers MH, Mori M, Cays MJ, Meyers JD (1991) Use of leukocyte-depleted platelets and cytomegalovirus-seronegative red blood cells for prevention of primary cytomegalovirus infection after marrow transplant. Blood 78:246–250

    Google Scholar 

  13. Bratanow NC, Ash RC, Turner PA (1987) Successful treatment of serious cytomegalovirus (CMV) disease with 9(1,3-dihydroxy-2-propoxymethyl)guanine (ganciclovir) DHPG) and intravenous immunoglobulin (IVIG) in bone marrow transplant (BMT) patients (abstract 254). Exp Hematol 15:541

    Google Scholar 

  14. Buchwald D, Cheney PR, Peterson DL, et al (1992) A chronic illness characterized by fatigue, neurologic and immunologic disorders, and active human herpesvirus type 6 infection. Ann Intern Med 116:103–113

    Google Scholar 

  15. Chang RS, Lewis JP, Reynolds RD, et al (1978) Oropharyngeal excretion of Epstein-Barr virus by patients with lymphoproliferative disorders and by recipients of renal homografts. Ann Intern Med 88:34

    Google Scholar 

  16. Coker DD, Morris DM, Coleman JJ, et al (1983) Infection among 210 patients with surgically staged Hodgkin's disease. Am J Med 75:97

    Google Scholar 

  17. Cone RW, Hackman RC, Huang MLW, et al (1993) Human herpesvirus 6 in lung tissue from patients with pneumonitis after bone marrow transplantation. N Engl J Med 329:156–161

    Google Scholar 

  18. Corey L, Spear PG (1986) Infections with herpes simplex viruses. II. Infections with herpes simplex viruses. N Engl J Med 14:686–749

    Google Scholar 

  19. De Witte T, Schattenberg A, Van Dijk BA, Galama J, Olthuis H, Van Der Meer JWW, Kunst VAJM (1990) Prevention of primary cytomegalovirus infection after allogeneic bone marrow transplantation by using leukocyte-poor random blood products from cytomegalovirus-unscreened blood-bank donors. Transplantation 50:964–968

    Google Scholar 

  20. Einsele H, Steidle M, Vallbracht A, Saal JG, Ehninger G, Muller CA (1991) Early occurrence of human cytomegalovirus infection after bone marrow transplantation as demonstrated by the polymerase chain reaction technique. Blood 77:1104–1110

    Google Scholar 

  21. Emanuel D, Cunningham I, Jules-Elysee K, et al (1988) Cytomegalovirus pneumonia after bone marrow transplantation succesfully treated with the combination of ganciclovir and high-dose intravenous immune globulin. Ann Intern Med 109:777–782

    Google Scholar 

  22. Englund JA, Sullivan CJ, Jordan MC, Dehner LP, Vercellotti GM, Balfour HH Jr (1988) Respiratory syncytial virus infection in immunocompromised adults. Ann Intern Med 109:203–208

    Google Scholar 

  23. Englund JA, Zimmerman ME, Swierkosz EM, et al (1990) Herpes simplex virus resistant to acyclovir: a study in a tertiary care center. Ann Intern Med 112:416

    Google Scholar 

  24. Feldman S, Lott L (1987) Varicella in children with cancer: impact of antiviral therapy and prophylaxis. Pediatrics 80:465

    Google Scholar 

  25. Gershon AA (1985) Live attenuated varicella vaccine: perspective. J Infect Dis 152:859

    Google Scholar 

  26. Gershon AA (1987) Live attenuated varicella vaccine. J Pediatr 110:154

    Google Scholar 

  27. Gershon AA, Steinberg SP, and the Varicella Vaccine Collaborative Study Group of the NIAID (1989) Persistence of immunity of varicella in children with leukemia immunized with live attenuated varicella vaccine. N Engl J Med 320:892

    Google Scholar 

  28. Gershon A, LaRussa P, Steinberg S (1992) Varicella zoster virus. In: Lennette EH (ed) Laboratory diagnosis of viral infections. Dekker, New York, pp 749–765

    Google Scholar 

  29. Gleaves CA, Smith TF, Shuster EA, Pearson GR (1984) Rapid detection of cytomegalovirus in MRC-5 cells inoculated with urine specimens by using low-speed centrifugation and monoclonal antibody to an early antigen. J Clin Microbiol 19:917–919

    Google Scholar 

  30. Goffinet DR, Glatstein EJ, Merigan TC (1972) Herpes Zoster-varicella infections and lymphoma. Ann Intern Med 76:235

    Google Scholar 

  31. Goodpasture EW (1929) Herpetic infection, with especial reference to involvement of the nervous system. Medicine 8:223–243

    Google Scholar 

  32. Goodrich JM, Mori M, Gieaves CA, et al (1991) Early treatment with ganciclovir to prevent cytomegalovirus disease after allogeneic bone marrow transplant. N Engl J Med 325:1601–1607

    Google Scholar 

  33. Goodrich JM, Bowden RA, Fisher L, et al (1993) Ganciclovir prophylaxis to prevent cytomegalovirus disease after allogeneic marrow transplant. Ann Intern Med 118:173–178

    Google Scholar 

  34. Gratama JW, Zwaan FE, Stijnen T, et al (1987) Herpes virus immunity and acute graft-versus-host disease. Lancet 1:471–474

    Google Scholar 

  35. Gratama JW, Oosterveer MAP, Lepoutre JMM, et al (1990) Epstein-Barr virus infection in allogeneic marrow grafting: lessons for transplant physicians and virologists. Ann Hematol 64:A162-A165

    Google Scholar 

  36. Gratama JW, Stijnen T, Weiland HT, et al (1991) Herpes virus immunity and acute graft-versus-host disease: an update from Leiden. In: Gale RP, Champlin R (eds) New strategies in bone marrow transplantation. Liss, New York, pp 311–318

    Google Scholar 

  37. Gratama JW, Zutter MM, Minarovits J, et al (1991) Expression of Epstein-Barr virus-encoded growth transformation-associated proteins in lymphoproliferations of bone marrow transplant recipients. Int J Cancer 47:188–192

    Google Scholar 

  38. Gratama JW, Lennette ET, Lönnqvist B, et al (1992) Detection of multiple Epstein-Barr viral strains in allogeneic bone marrow transplant recipients. J Med Virol 37:39–47

    Google Scholar 

  39. Greenspan JS, Greenspan D, Lennette ET, et al (1985) Replication of Epstein-Barr virus within the epithelial cells of oral “hairy” leukoplakia, an AIDS-associated lesion. N Engl J Med 313:1564–1571

    Google Scholar 

  40. Gregory WW, Menegus MA (1983) Practical protocol for cytomegalovirus isolation: use of MRC-5 cell monolayers incubated for 2 weeks. J Clin Microbiol 17:605–609

    Google Scholar 

  41. Harrington RD, Hooton TM, Hackman R, et al (1992) An outbreak of respiratory syncytial virus in a bone marrow transplant center. J Infect Dis 165:987–993

    Google Scholar 

  42. Hirsch MS (1981) Herpes group virus infections in the compromised host. In: Rubin RH, Young LS (eds) Clinical approaches to infection in the compromised host, 1st edn. Plenum Press, New York, p 389

    Google Scholar 

  43. Ho M (1991) Cytomegalovirus: biology and infection 2nd edn. Plenum Press, New York

    Google Scholar 

  44. Hoagland RJ (1955) The transmission of infectious mononucleosis. Am J Med Sci 229:262–272

    Google Scholar 

  45. Jacobson MA, Berger TG, Fikrig S, et al (1990) Acyclovir-resistant varicella zoster virus infection after chronic oral acyclovir therapy in patients with the acquired immunodeficiency syndrome (AIDS). Ann Intern Med 112:187–191

    Google Scholar 

  46. Johnson JR, Egaas S, Gleaves CA, Hackman R, Bowden RA (1992) Hepatitis due to herpes simplex virus in marrow transplant recipients. Clin Infect Dis 14:38–45

    Google Scholar 

  47. Jordan MC, Pomeroy C (1990) Latent CMV infection in the mouse. Transplant Proc 23 [Suppl 3]:17–21

    Google Scholar 

  48. Kraemer KG, Neiman PE, Reeves WC, Thomas ED (1978) Prophylactic adenine arabinoside following marrow transplantation. Transplant Proc 10:237–240

    Google Scholar 

  49. Lawrence R, Gershon AA, Holzman R, et al (1988) The risk of zoster after varicella vaccination in children with leukemia. N Engl J Med 318:543

    Google Scholar 

  50. Leland DS, Hansing RL, French ML (1989) Clinical experiences with cytomegalovirus isolation using conventional cell cultures and early antigen detection in centrifugation-enhanced shell vial cultures. J Clin Microbiol 27:1159–1162

    Google Scholar 

  51. Ljungman P, Wilczek H, Gahrton G, et al (1986) Long-term acyclovir prophylaxis in bone marrow transplant recipients and lymphocyte proliferation responses to herpes virus antigens in vitro. Bone Marrow Transplant 1:185–192

    Google Scholar 

  52. Ljungman P, Lönnqvist B, Ringdén O, Skinhöj P, Gahrton G, for the Nordic bone Marrow Transplant Group (1989) A randomized trial of oral versus intravenous acyclovir for treatment of herpes zoster in bone marrow transplant recipients. Bone Marrow Transplant 4:613–615

    Google Scholar 

  53. Ljungman P, Ellis MN, Hackman RC, et al (1990) Acyclovir-resistant herpes simplex virus causing pneumonia after marrow transplantation. J Infect Dis 162:244

    Google Scholar 

  54. Locksley PRM, Flournoy N, Sullivan KM, Meyers JD (1985) Infection with varicella-zoster virus after marrow transplantation. J Infect Dis 152:1172–1181

    Google Scholar 

  55. McDonald GB, Sharma P, Hackman RC, et al (1985) Esophageal infections in immuno-suppressed patients after marrow transplantation. Gastroenterology 88:1111–1117

    Google Scholar 

  56. Meyers JD, Flournoy N, Thomas ED (1982) Nonbacterial pneumonia after allogeneic marrow transplantation: a review of ten years' experience. Rev Infect Dis 4:1119–1132

    Google Scholar 

  57. Meyers JD, McGuffin RW, Bryson YJ, Cantell K, Thomas ED (1982) Treatment of cytomegalovirus pneumonia after marrow transplant with combined vidarabine and human leukocyte interferon. J Infect Dis 146:80–84

    Google Scholar 

  58. Meyers JD, Wade JC, Mitchell CD, et al (1982) Multicenter collaborative trial of intravenous acyclovir for the treatment of mucocutaneous herpes simplex virus infection in the immunocompromised host. Am J Med 73A:229

    Google Scholar 

  59. Meyers JD, Wade JC, Shepp DH, Newton B (1984) Acyclovir treatment of varicella-zoster virus infection in the compromised host. Transplantation 37:571

    Google Scholar 

  60. Meyers JD, Flournoy N, Thomas ED (1986) Risk factors for cytomegalovirus infection after human marrow transplantation. J Infect Dis 153:478–488

    Google Scholar 

  61. Meyers JD, Flournoy N, Sanders JE, et al (1987) Prophylactic human leukocyte interferon after allogeneic marrow transplantation. Ann Intern Med 107:809

    Google Scholar 

  62. Meyers JD, Reed EC, Shepp DH, et al (1988) Acyclovir for prevention of cytomegalovirus infection and disease after allogeneic marrow transplantation. N Engl J Med 318:70

    Google Scholar 

  63. Miller W, Flynn P, McCullough J, et al (1986) Cytomegalovirus infection after bone marrow transplantation: an association with acute graft-versus-host disease. Blood 67:1162–1167

    Google Scholar 

  64. Miller WJ, McCullough J, Balfour HH, Jr, et al (1991) Prevention of cytomegalovirus infection following bone marrow transplantation: a randomized trial of blood product screening. Bone Marrow Transplant 7:227–234

    Google Scholar 

  65. Mitchell CD, Gentry SR, Boen JR, et al (1981) Acyclovir therapy for mucocutaneous herpes simplex infections in immunocompromised patients. Lancet II:1389

    Google Scholar 

  66. Nilsson K, Klein G, Henle W, Henle G (1971) The establishment of lymphoblastoid cell lines from adult and from foetal human lymphoid tissue and its dependence on EBW. Int J Cancer 8:443–450

    Google Scholar 

  67. Nolte FS, Emmens RK, Thumond C, et al (1993) Early detection of cytomegalovirus viremia in bone marrow transplant recipients by DNA amplification (abstract 1545). Programs & Abstracts of 33rd ICAAC, New Orleans, La, p 140

  68. Perren TJ, Powles RL, Easton D, et al (1988) Prevention of herpes zoster in patients by long-term oral acyclovir after allogeneic bone marrow transplantation. Am J Med 85:99–101

    Google Scholar 

  69. Pruneda RC, Almanza I (1987) Centrifugation-shell vial technique for rapid detection of herpes simplex virus cytopathic effect in vero cells. J Clin Microbiol 25:423

    Google Scholar 

  70. Quinnan GV, Kirmani N, Rook AH, et al (1982) Cytotoxic T cells in cytomegalovirus infection: HLA-restricted T-lymphocyte and non T-lymphocyte cytoxic responsed correlate recovery from cytomegalovirus in bone marrow recipients. N Engl J Med 307:7–13

    Google Scholar 

  71. Ramsey PG, Fife FH, Hackman RC, Meyers JD, Corey L (1982) Herpes simplex virus pneumonia. Ann Intern Med 97:813–820

    Google Scholar 

  72. Reed EC, Dandliker PS, Meyers JD (1986) Treatment of cytomegalovirus pneumonia with 9-[2-hydroxy-1-(hydroxymethyl)ethoxymethyl] guanine and high dose corticosteroids. Ann Intern Med 105:214–216

    Google Scholar 

  73. Reed EC, Bowden RA, Dandliker PS, et al (1987) Efficacy of cytomegalovirus immunoglobulin in marrow transplant recipients with cytomegalovirus pneumonia. J Infect Dis 156:641

    Google Scholar 

  74. Reed EC, Bowden RA, Dandliker PS, et al (1988) Treatment of cytomegalovirus pneumonia with ganciclovir and intravenous cytomegalovirus immunoglobulin in patients with bone marrow transplants. Ann Intern Med 109:783–788

    Google Scholar 

  75. Reed EC, Wolford JL, Kopecky KJ, et al (1990) Ganciclovir for the treatment of cytomegalovirus gastroenteritis in bone marrow transplant patients. A randomized, placebo-controlled trial. Ann Intern Med 112:505–510

    Google Scholar 

  76. Reeves WC, Corey L, Adams HG, et al (1981) Risk of recurrence after first episodes of genital herpes. Relation to HSV type and antibody response. N Engl J Med 305:315

    Google Scholar 

  77. Reusser P, Riddel SR, Meyers JD, Greenberg PD (1991) Cytotoxic T-lymphocyte response to cytomegalovirus after human allogeneic bone marrow transplantation: pattern of recovery and correlation with cytomegalovirus infection and disease. Blood 78:1373–1380

    Google Scholar 

  78. Sacks SL, Wanklin RJ, Reece DE, Hicks KA, Tyler KL, Coen DM (1989) Progressive esophagitis from acyclovir-resistant herpes simplex. Clinical roles for DNA polymerase mutants and viral heterogeneity? Ann Intern Med 111:893–899

    Google Scholar 

  79. Safrin S, Assakeen T, Follansbee S, Mills J (1990) Foscarnet therapy for acyclovir-resistant mucocutaneous herpes simplex virus infection in 26 AIDS patients: preliminary data. J Infect Dis 161:1078

    Google Scholar 

  80. Safrin S, Berger TG, Gilson I, et al (1991) Foscarnet therapy in five patients with AIDS and acyclovir-resistant varicella-zoster virus infection. Ann Intern Med 115:19–21

    Google Scholar 

  81. Salahuddin SZ, Ablashi DV, Markham PD, et al (1986) Isolation of a new virus, HBLV, in patients with lymphoproliferative disorders. Science 234:596–600

    Google Scholar 

  82. Saral R, Burns WH, Laskin OL, et al (1981) Acyclovir prophylaxis of herpes-simplex-virus infections. A randomized, double-blind, controlled trial in bone marrow transplant recipients. N Engl J Med 305:63

    Google Scholar 

  83. Saral R, Ambinder RF, Burns WH, et al (1983) Acyclovir prophylaxis against recrudescent herpes simplex virus infections in leukemia patients: a randomized, double-blind placebo controlled study. Ann Intern Med 99:773

    Google Scholar 

  84. Schiller GJ, Nimer SD, Gajewski JL, Golde DW (1991) Abdominal presentation of varicella-zoster infection in recipients of allogenic bone marrow transplantation. Bone Marrow Transplant 7:489–491

    Google Scholar 

  85. Schmidt GM, Kovasc A, Zaia JA, et al (1988) Ganciclovir/immunoglobulin combination therapy for the treatment of human cytomegalovirus-associated interstitial pneumonia in bone marrow allograft recipients. Transplantation 46:905–907

    Google Scholar 

  86. Schmidt GM, Horak DA, Niland JC, et al (1991) A randomized, controlled trial of prophylactic ganciclovir for cytomegalovirus pulmonary infection in recipients of allogeneic bone marrow transplant patients. N Engl J Med 324:1005–1011

    Google Scholar 

  87. Schmidt NJ, Ballo D, Devlin V, Woodie JD, Emmons RW (1980) Direct immuno-fluorescence staining for detection of herpes simplex and varicella-zoster virus antigens in vesicular lesion and certain tissue speciments. J Clin Microbiol 12:651–655

    Google Scholar 

  88. Schuchter LM, Wingard JR, Piantadosi S, Burns WH, Santos GW, Saral R (1989) Herpes zoster infection after autologous bone marrow transplantation. Blood 74:1424–1427

    Google Scholar 

  89. Selby PJ, Jameson B, Watson JG, et al (1980) Parenteral acyclovir therapy for herpes virus infections in man. Lancet II:1267

    Google Scholar 

  90. Sempere A, Sanz GF, Senent L, et al (1992) Long-term acyclovir prophylaxis for prevention of varicella zoster virus infection after autologous blood stem cell transplantation in patients with acute leukemia. Bone Marrow Transplant 10:495–498

    Google Scholar 

  91. Shapiro RS, McClain K, Frizzra G, et al (1988) Epstein-Barr virus associated B cell lymphoproliferative disorders following bone marrow transplantation. Blood 71:1234–1243

    Google Scholar 

  92. Shepp DH, Dandliker PS, deMiranda P, et al (1985) Activity of 9-[2-hydroxy-1-(hydroxymethyl)ethoxyme-thyl]guanine in the treatment of cytomegalovirus pneumonia. Ann Intern Med 103:368

    Google Scholar 

  93. Shepp DH, Newton BA, Dandliker PS, et al (1985) oral acyclovir therapy for mucocutaneous herpes simplex virus infection in immunocompromised marrow transplant recipients. Ann Intern Med 102:783

    Google Scholar 

  94. Shepp DH, Dandliker PS, Meyers JD (1986) Treatment of varicellazoster virus infection in severely immunocompromised patients: a randomized comparison of acyclovir and vidarabine. N Engl J Med 314:208–212

    Google Scholar 

  95. Shields AF, Hackman RC, Fife KH, Corey L, Meyers JD (1985) Adenovirus infections in patients undergoing bone marrow transplantation. N Engl J Med 312:529–533

    Google Scholar 

  96. Sixbey JW, Nedrud JG, Raab-Traub N, Hanes RA, Pagano JS (1984) Epstein-Barr virus replication in oropharyngeal epithelial cells. N Engl J Med 310:1225–1230

    Google Scholar 

  97. Strauch B, Siegel N, Andrews LL, et al (1974) Oropharyngeal excretion of Epstein-Barr virus by renal transplant recipients and other patients treated with immunosuppressive drugs. Lancet I:234

    Google Scholar 

  98. Straus SE, Cohen JI, Tosato G, Meier J (1993) Epstein-Barr virus infections: biology, pathogenesis and management. Ann Intern Med 118:45–48

    Google Scholar 

  99. Sullivan KM, Kopecky KJ, Jocum J, et al (1990) Immunomodulatory and antimicrobial efficacy of intravenous immunoglobulin in bone marrow transplantation. N Engl J Med 323:705–712

    Google Scholar 

  100. Swenson PD, Kaplan MH (1985) Rapid detection of cytomegalovirus in cell culture by indirect immunoperoxidase staining with monoclonal antibody to an early nuclear antigen. J Clin Microbiol 21:669–673

    Google Scholar 

  101. Townsend TR, Bolvard EA, Yolken RH, et al (1982) Outbreak of coxsackie A1 gastroenteritis: a complication of bone marrow transplantation. Lancet I:820–823

    Google Scholar 

  102. Vaughan WP, Saral R, Anderson LR, Burke PJ (1981) The frequency and pattern of cytomegalovirus (CMV) infection and shedding by patients who have received high dose times-sequential chemotherapy (TSC) for acute myelocytic leukemia (AML) (abstract 673). Proceedings of the 17th Annual Meeting of the American Society of Clinical Oncology. Saunders, Philadelphia, p 170

    Google Scholar 

  103. Wade JC, Hintz M, McGuffin RW, et al (1982) Treatment of cytomegalovirus pneumonia with high-dose acyclovir. Am J Med 73A:249

    Google Scholar 

  104. Wade JC, Newton B, McLaren C, et al (1982) Treatment of mucocutaneous herpes simplex virus infection after marrow transplantation with intravenous acyclovir: a double-blind trial. Ann Intern Med 96:265

    Google Scholar 

  105. Wade JC, McGuffin RW, Springmeyer SC, Newton B, Singer JW, Meyers JD (1983) Treatment of cytomegaloviral pneumonia with high-dose acyclovir and human leukocyte interferon. J Infect Dis 148:557–562

    Google Scholar 

  106. Wade JC, McLaren C, Meyers JD (1983) Frequency and significance of acyclovir-resistant herpes simplex virus isolated from marrow transplant patients receiving multiple courses of treatment with acyclovir. J Infect Dis 148:1077–1082

    Google Scholar 

  107. Wade JC, Newton B, Flournoy N, Meyers JD (1984) Oral acyclovir prophylaxis of herpes simplex virus infection after marrow transplant. Ann Intern Med 100:823

    Google Scholar 

  108. Weiner RS, Bortin MM, Gale RP, et al (1986) Interstitial pneumonitis after bone marrow transplantation. Ann Intern Med 104:168–175

    Google Scholar 

  109. Wendt CH, Weisdorf DJ, Jordan MC, Balfour HH, Hertz MI (1992) Parainfluenza virus respiratory infection after bone marrow transplantation. N Engl J Med 326:921–926

    Google Scholar 

  110. Whitley RJ, Gnann JW (1992) Acyclovir: a decade later. N Engl J Med 327:782–789

    Google Scholar 

  111. Whitley RJ, Soong S-J, Dolin R, et al (1977) Adenine arabinoside therapy of biopsy-proved herpes simplex encephalitis. N Engl J Med 297:289–294

    Google Scholar 

  112. Whitley RJ, Spruance S, Hayden FG, et al (1984) Vidarabine therapy for mucocutaneous herpes simplex virus infections in the immunocompromised host. J Infect Dis 149:1–8

    Google Scholar 

  113. Wingard JR (1990) Infectious and noninfectious systemic consequences. Oral complications of cancer therapies: diagnosis, prevention, and treatment. Natl Cancer Inst Monogr 9:21–26

    Google Scholar 

  114. Wingard JR, Chen DY-H, Burns WH, et al (1988) Cytomegalovirus infection after autologous bone marrow transplantation: comparison to infection after allogeneic bone marrow transplantation. Blood 71:1432–1437

    Google Scholar 

  115. Wingard JR, Mellits ED, Sostrin MB, et al (1988) Interstitial pneumonitis after allogeneic bone marrow transplantation: nine-year experience at a single institution. Medicine (Baltimore) 67:175–186

    Google Scholar 

  116. Wingard JR, Piantadosi S, Burns WH, et al (1990) Cytomegalovirus infections in patients treated by intensive cytoreductive therapy with marrow transplant. Rev Infect Dis 12 [Suppl 7]:S805–810

    Google Scholar 

  117. Wingard JR, Lin SC, Mar EC, devine SM, Pascuzzi CC, Dix SP, Saral R, Lin JC (1994) Epstein-Barr Virus (EBV) infection in bone marrow transplant (BMT) patients (abstract G116). J Cell Biochem 18:62

    Google Scholar 

  118. Winston DJ, Ho WG, Lin CH, et al (1987) Intravenous immune globulin for prevention of cytomegalovirus infection and interstitial pneumonia after bone marrow transplantation. Ann Intern Med 106:12–18

    Google Scholar 

  119. Winston DJ, Ho WG, Champlin RE (1990) Cytomegalovirus infections after allogeneic bone marrow transplantation. Rev Infect Dis 12 [Suppl 7]:S776–792

    Google Scholar 

  120. Winston DJ, Ho WG, Bartoni K, et al (1993) Ganciclovir prophylaxis of cytomegalovirus infection and disease in allogeneic bone marrow transplant recipients. Ann Intern Med 118:179–184

    Google Scholar 

  121. Yolken RH, Bishop CA, Townsend TR, et al (1982) Infectious gastroenteritis in bone marrow transplant recipients. N Engl J Med 306:1009–1012

    Google Scholar 

  122. Yoshikawa T, Suga S, Asano Y, et al (1991) Human herpesvirus-6 infection in bone marrow transplantation. Blood 78:1381–1384

    Google Scholar 

  123. Young L, Alfieri C, Hennessy K, et al (1989) Expression of Epstein-Barr virus transformation-associated genes in tissues of patients with EBV lymphoproliferative disease. N Engl J Med 321:1080–1085

    Google Scholar 

  124. Zaia JA, Levin MJ, Preblud SR, et al (1983) Evaluation of varicella-zoster immune globulin: protection of immunosuppressed children after household exposure to varicella. J Infect Dis 147:737

    Google Scholar 

  125. Zaia JA, Forman SJ, Ting Y-P, Vanderwal-Urbina E, Blume KG (1986) Polypeptide-specific antibody response to human cytomegalovirus after infection in bone marrow transplant recipients. J Infect Dis 153:780–787

    Google Scholar 

  126. Zutter MM, Martin PJ, Sale GE, et al (1988) Epstein-Barr virus lymphoproliferation after bone marrow transplantation. Blood 72:520–529

    Google Scholar 

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Devine, S.M., Wingard, J.R. Viral infections in severely immunocompromised cancer patients. Support Care Cancer 2, 355–368 (1994). https://doi.org/10.1007/BF00344048

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