| Recommendations | Proven respiratory syncytial virus (RSV) in high-risk patients*
IG may be used to prevent progression to lower respiratory tract infection.
*Note The term “high-risk patient” signifies:
- Lung transplant recipients.
- Allogeneic HSCT recipients with at least one of the following:
- hypogammaglobulinemia, defined as an IgG level less than the lower limit of normal or <4 g/L
- absolute lymphocyte count <0.5 x 109/L
- CD4 T-cell count <0.2 x 109/L
- 6 months post alemtuzumab, anti-thymocyte globulin, rituximab therapy, or other B-cell depleting therapy (e.g., blinatumomab)
- steroid refractory or steroid dependent acute graft-versus-host disease
- moderate to severe chronic graft-versus-host disease; or
- Prolonged use of systemic corticosteroids at a dose of at least 0.5 mg prednisone equivalents/kg/day for at least 1 week.
- Recipients of chimeric antigen receptor T-cells (CAR-T) for relapsed or refractory acute leukemia, multiple myeloma, chronic lymphocytic leukemia, or non-Hodgkin lymphoma (or other indication) with ongoing evidence of B-cell lymphopenia who are not receiving regular immunoglobulin replacement.
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