title: Varicella zoster virus infection during chemotherapy in solid cancer patients.
abstract: BACKGROUND
  Varicella zoster virus (VZV) infection is a representative opportunistic infection in patients with hematological malignancies, with a high incidence of 30-50%. Many studies on the risk factors of VZV infection in this patient group have been conducted. However, few data have been reported exploring VZV infection during systemic chemotherapy in solid cancer patients.
  
  
  METHODS
  We retrospectively analyzed 92 patients diagnosed with VZV infection between April 2001 and July 2010 during systemic chemotherapy for solid tumors. All patients had received antiviral prophylaxis for VZV.
  
  
  RESULTS
  The median age at the time of diagnosis of VZV infection was 60.8 years (range 30.1-83.0) and the majority of patients (79.3%) did not have comorbidities. Eighty-one patients (88%) received chemotherapy for locally advanced or metastatic/recurrent disease and 11 (12.0%) had adjuvant chemotherapy after curative resection. Of 92 patients, 14 (15.2%) had non-small cell lung cancer and 10 (10.9%) breast cancer. All patients had a median of 2 metastatic lesions (range 0-4). At the time of diagnosis, 55 patients (59.8%) were receiving first-line chemotherapy and 15 (16.3%) more than third-line chemotherapy. The mean white blood cell, platelet and albumin level was 5,736/μl, 205.7 × 10(3) and 3.8 mg/dl, respectively. On analysis for disease evaluation at the time nearest to diagnosis of VZV infection, only 14 patients (15.2%) revealed tumor response to chemotherapy. After the diagnosis of VZV infection, all patients were treated with antiviral agents. None of the patients experienced failure of therapy for VZV.
  
  
  CONCLUSIONS
  We reported VZV infection during systemic chemotherapy in solid cancer patients. Patients may have a relatively poor tumor response to chemotherapy at the time nearest to diagnosis of VZV infection. A prospective or matched controlled trial is needed to confirm this finding.
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Seung Tae
authors.initials: ST
authors.lastname: Kim
authors.forename: Kyong Hwa
authors.initials: KH
authors.lastname: Park
authors.forename: Sang Cheul
authors.initials: SC
authors.lastname: Oh
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: Seo
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Shin
authors.forename: Jun Suk
authors.initials: JS
authors.lastname: Kim
authors.forename: Yeul Hong
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D006562:Herpes Zoster / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000276:immunology; D009894:Opportunistic Infections / Q000209:etiology*; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents