title: Varicella zoster virus reactivation after autologous SCT is a frequent event and associated with favorable outcome in myeloma patients.
abstract: The occurrence of varicella zoster virus (VZV) reactivation is increased after allogeneic transplantation, whereas limited data are available for herpes zoster (HZ) after autologous SCT (ASCT). We determined the incidence and the prognostic significance of HZ and its correlation with VZV serology in 191 consecutive myeloma patients undergoing high-dose melphalan chemotherapy with ASCT. We found that VZV reactivation occurred in 57 (30%) patients, in 8.5% during induction and in 21.5% after ASCT peaking at 8 months after ASCT. Disease burden due to HZ was assessed as high or rather high in 70% of the patients. By immune fluorescence and Serion Elisa VZV IgG assessment, 90.8% of all patients had specific anti-VZV antibodies at ASCT. Lower specific antibody titers at transplantation were observed in patients with HZ after ASCT than in those without reactivation (P=0.009). Finally, OS was better in myeloma patients with HZ after ASCT compared with patients without HZ (P=0.007). Our data indicate that VZV reactivation after ASCT is a frequent event carrying a significant disease burden and it is associated with improved survival. Low levels of specific VZV antibodies at ASCT suggest increased vulnerability for VZV reactivation.
authors.affiliation: Department of Medical Oncology, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Kamber
authors.affiliation: Department of Infectious Diseases, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Zimmerli
authors.affiliation: Department of Infectious Diseases, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Suter-Riniker
authors.affiliation: Department of Clinical Research, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: B U
authors.initials: BU
authors.lastname: Mueller
authors.affiliation: Department of Hematology, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: B M
authors.initials: BM
authors.lastname: Taleghani
authors.affiliation: Department of Oncology, Cantonal Hospital, Fribourg, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Betticher
authors.affiliation: Department of Medical Oncology, Cantonal Hospital, Lucerne, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Zander
authors.affiliation: Department of Medical Oncology, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Pabst
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D064592:Autografts; D018572:Disease-Free Survival; D005260:Female; D006562:Herpes Zoster / Q000097:blood / Q000209:etiology / Q000401:mortality; D014645:Herpesvirus 3, Human / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000401:mortality / Q000628:therapy / Q000821:virology; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014775:Virus Activation
chemical_list: D000914:Antibodies, Viral