title: Varicella-zoster virus infection in adult patients after unrelated cord blood transplantation: a single institute experience in Japan.
abstract: Varicella-zoster virus (VZV) infection was studied in 40 adult patients who underwent cord blood transplantation (CBT) from unrelated donors. Twenty-five patients developed VZV reactivation at a median of 5 months after CBT (range 1.7-26 months). The cumulative incidence of VZV reactivation after CBT was 80% at 30 months. Twenty-two patients developed localized herpes zoster. The remaining three patients developed atypical non-localized herpes zoster, which was associated with visceral dissemination in one patient. All the patients responded well to antiviral therapy. Unexpectedly, the absence of grade II-IV acute graft-versus-host disease (GVHD) was associated with a higher rate of VZV reactivation after CBT (100% versus 55%, P=0.01). These results suggest that recovery of VZV-specific immune responses after CBT is delayed even in patients without severe acute GVHD.
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan. atomonar@ims.u-tokyo.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Tomonari
authors.forename: Tohru
authors.initials: T
authors.lastname: Iseki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Jun
authors.initials: J
authors.lastname: Ooi
authors.forename: Kashiya
authors.initials: K
authors.lastname: Takasugi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Shimohakamada
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ohno
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Nagamura
authors.forename: Kaoru
authors.initials: K
authors.lastname: Uchimaru
authors.forename: Kenzaburo
authors.initials: K
authors.lastname: Tani
authors.forename: Arinobu
authors.initials: A
authors.lastname: Tojo
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Asano
mesh_terms: D000208:Acute Disease; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease; D006402:Hematologic Diseases / Q000276:immunology / Q000601:surgery* / Q000821:virology; D006562:Herpes Zoster / Q000188:drug therapy / Q000276:immunology*; D014645:Herpesvirus 3, Human / Q000502:physiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D019172:Transplantation Conditioning; D014775:Virus Activation
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir