Varicella-zoster virus disease is more frequent after cord blood than after bone marrow transplantation.
Immune reconstitution may differ following cord blood transplantation (CBT) and bone marrow transplantation (BMT), and this may lead to a difference in varicella zoster virus (VZV) disease rates. One hundred fourteen VZV seropositive children received a CBT (37 patients), or a T-replete BMT (77 patients) at our institution. Patients did not received specific VZV disease prophylaxis. VZV disease was diagnosed by immunofluorescence or culture in 41 (36%) patients. In multivariate analysis, VZV disease was more frequent in older children (relative risk [RR] 1.11 per year; 95% confidence interval [CI], 1.04-1.18; P = .002), and after CBT (RR 2.27; 95% CI, 1.18-4.34; P = .013). The cumulative incidence of VZV disease at 3 years posttransplant was 46% following CBT. VZV disease incidence was 71% in CBT patients over 10 years old at transplant. Visceral dissemination occurred in 7 patients (6 CBT and 1 BMT) (P = .005). VZV disease is thus more frequent and more severe after CBT than after BMT.
Vandenbosch
Kristel
K
Groupe de Recherche en Immunologie et Transplantation de Sang de Cordon, Service d'Hématologie-Oncologie, Centre de Cancérologie Charles-Bruneau, Montréal, Québec, Canada.
Ovetchkine
Philippe
P
Champagne
Martin A
MA
Haddad
Elie
E
Alexandrov
Lubomir
L
Duval
Michel
M
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D005260:Female; D005767:Gastrointestinal Diseases / Q000821:virology; D006562:Herpes Zoster / Q000453:epidemiology / Q000209:etiology*; D014645:Herpesvirus 3, Human; D006801:Humans; D007107:Immune System / Q000166:cytology / Q000502:physiology; D015994:Incidence; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D011336:Probability; D012038:Regeneration