Herpes zoster infection after autologous bone marrow transplantation.
One hundred fifty-three patients who underwent autologous bone marrow transplant (ABMT) were studied retrospectively to determine the frequency, outcome, and risk-factors associated with varicella-zoster infections (VZV). Forty-three patients (28%) developed VZV infection after transplant. The median onset of infection was the fifth month, with 91% of cases occurring within the first year. Thirty-three patients (77%) had localized herpes zoster, and ten patients (23%) had varicella. Cutaneous dissemination developed in 15% of patients and probable visceral dissemination developed in 5%. Overall morbidity was 25% and included scarring, alopecia, postherpetic neuralgia, and neurologic dysfunction. There were no deaths from VZV infection. The majority of patients (79%) were treated with intravenous (IV) acyclovir. The only significant risk factor associated with VZV infection was the underlying disease. VZV infection occurred most frequently in patients with Hodgkin's and non-Hodgkin's lymphoma (46%) as compared with patients with leukemia (23%) or solid tumors (9%) (P less than .002). The frequency of VZV infection in ABMT patients appears to be comparable to that reported for allogeneic BMT patients and other immunocompromised patients.
Schuchter
L M
LM
Johns Hopkins Oncology Center, Baltimore.
Wingard
J R
JR
Piantadosi
S
S
Burns
W H
WH
Santos
G W
GW
Saral
R
R
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006562:Herpes Zoster / Q000188:drug therapy / Q000209:etiology*; D014645:Herpesvirus 3, Human; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000150:complications / Q000601:surgery; D008223:Lymphoma / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012874:Skin Diseases, Infectious / Q000209:etiology; D014182:Transplantation, Autologous