[Analysis of varicella zoster virus infection following allogeneic stem cell transplants].
The purpose of this study was to evaluate patients who contracted the varicella zoster virus infection (VZV) following their allogeneic stem cell transplants. We retrospectively reviewed the incidence and the timing of varicella zoster virus (VZV) infections, including the clinical course, complications, and associated clinical risk factors. Between January 1998 and April 2003, a total of 71 patients received allogeneic stem cell transplants in our hospital. For prophylaxis of the herpes virus infection, all patients were given a daily oral 1000 mg dose of acyclovir from day -7 to day +35. Among the 71 patients, 28 of them (39.4%) developed VZV infection between day 77 and day 980 (median 182 days) following their allogeneic stem cell transplants. In 21 of these infected patients (75%) the occurrence was within the first 300 days after the transplant. Twenty-two patients (78.5%) were under treatment with immunosuppressive agents. Twenty-six patients developed only one episode of the VZV infection after their transplants, but two other patients developed two episodes. Twenty one patients (75%) stricken with the VZV infections had cutaneous reactivation infections of a single dermatome, and in one patient two dermatomes were affected. Five patients (17.8%) developed disseminated cutaneous zoster, and one patient (3.6%) developed a visceral infection. Treatment with acyclovir (oral or drip infusion) was successful in 25 patients. Two patients improved with vidarabine treatment, however the patient with the visceral infection died despite the use of acyclovir. The incidence of visceral infection was low, but the one case was fatal.
Doki
Noriko
N
Division of Hematology, Saiseikai Maebashi Hospital.
Hoshino
Takumi
T
Irisawa
Hiroyuki
H
Sakura
Tohru
T
Miyawaki
Shuichi
S
D000212:Acyclovir / Q000008:administration & dosage; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage; D005260:Female; D006561:Herpes Simplex / Q000517:prevention & control; D006562:Herpes Zoster / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011379:Prognosis; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D013997:Time Factors; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000627:therapeutic use
D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D014740:Vidarabine; D000212:Acyclovir