The risk factors for herpes zoster in bortezomib treatment in patients with multiple myeloma.
BACKGROUND
Bortezomib has significant activity in treating multiple myeloma (MM). The risk of herpes zoster (HZ) has been reported to increase significantly with bortezomib treatment, but the predisposing factors for HZ are not clear. This study is a retrospective analysis of the relevant risk factors for HZ in Korean MM patients treated with bortezomib.


METHODS
Sixty-six patients with refractory or relapsed MM who underwent chemotherapy with bortezomib were included in the study. Prophylactic antiviral drugs were not used for treatment. The following parameters were reviewed: age, gender, stage and type of MM, extent of previous treatment, history of HZ, duration from the time of diagnosis to the time of bortezomib treatment initiation, and absolute lymphocyte counts (ALC) at the time of bortezomib treatment initiation.


RESULTS
The incidence of HZ was 16.7%. There were no intergroup differences between the HZ-positive and the HZ-negative groups with regard to a history of HZ, number of previous treatments, and exposure to steroids before bortezomib treatment. The median duration from the time of MM diagnosis to the time of bortezomib treatment initiation in the HZ-positive group was significantly shorter than that in the HZ-negative group. The median ALC at the time of bortezomib initiation in the HZ-positive group was significantly lower than that in the HZ-negative group.


CONCLUSIONS
Bortezomib itself might act as a risk factor for HZ by inhibiting cell-mediated immunity, and patients with low ALC at the time of bortezomib treatment initiation were at greater risk of HZ during bortezomib treatment.
Department of Hematology-Oncology, Busan Cancer Center, Pusan National University Hospital Medical Research Institute, Busan, Korea.
Yang-Seon
YS
Yi
Joo-Seop
JS
Chung
Moo-Kon
MK
Song
Ho-Jin
HJ
Shin
Young-Mi
YM
Seol
Young-Jin
YJ
Choi
Goon-Jae
GJ
Cho
Gyeong-Won
GW
Lee
Joon-Ho
JH
Moon
In-Hye
IH
Hwang
Kang-Hee
KH
Ahn
Hee-Sun
HS
Lee
Kyung-Hwa
KH
Shin
Jong-Min
JM
Hwang