title: Varicella-zoster virus disease is more frequent after cord blood than after bone marrow transplantation.
abstract: 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.
authors.affiliation: Groupe de Recherche en Immunologie et Transplantation de Sang de Cordon, Service d'Hématologie-Oncologie, Centre de Cancérologie Charles-Bruneau, Montréal, Québec, Canada.
authors.forename: Kristel
authors.initials: K
authors.lastname: Vandenbosch
authors.forename: Philippe
authors.initials: P
authors.lastname: Ovetchkine
authors.forename: Martin A
authors.initials: MA
authors.lastname: Champagne
authors.forename: Elie
authors.initials: E
authors.lastname: Haddad
authors.forename: Lubomir
authors.initials: L
authors.lastname: Alexandrov
authors.forename: Michel
authors.initials: M
authors.lastname: Duval
mesh_terms: 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