title: Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus and varicella zoster virus diseases after autologous hematopoietic stem cell transplantation.
abstract: Limited data are available on prophylaxis for herpes simplex virus (HSV) and varicella zoster virus (VZV) disease following autologous hematopoietic stem cell transplantation (auto-HCT). We retrospectively reviewed the clinical charts of 105 consecutive patients who underwent their first auto-HCT at our institution between September 2007 and June 2014. Before August 2009, 30 patients received oral acyclovir at 1000 mg/day until engraftment, whereas after September 2009, 69 patients received oral acyclovir at 200 mg/day. After engraftment, acyclovir was continued at 200 mg/day at the discretion of the attending physicians in both groups. The cumulative incidence of HSV disease at 1 year after auto-HCT was 7.7 and 4.5 % in patients who received oral acyclovir at 1000 and 200 mg/day, respectively (P = 0.75). Patients were next divided into three groups according to the timing at which acyclovir prophylaxis was stopped after auto-HCT; at engraftment, between engraftment and 1 year after auto-HCT, and later than 1 year. The cumulative incidence of VZV disease was 25.8, 7.7, and 0.0 % at 1 year, respectively. This study suggests that low-dose acyclovir prophylaxis may be effective for preventing HSV and VZV disease after auto-HCT. Our findings support the recommendation of acyclovir prophylaxis within the first year after auto-HCT.
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kawamura
authors.forename: Jin
authors.initials: J
authors.lastname: Hayakawa
authors.forename: Yu
authors.initials: Y
authors.lastname: Akahoshi
authors.forename: Naonori
authors.initials: N
authors.lastname: Harada
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nakano
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Kameda
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Ugai
authors.forename: Hidenori
authors.initials: H
authors.lastname: Wada
authors.forename: Ryoko
authors.initials: R
authors.lastname: Yamasaki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ishihara
authors.forename: Kana
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ashizawa
authors.forename: Miki
authors.initials: M
authors.lastname: Sato
authors.forename: Kiriko
authors.initials: K
authors.lastname: Terasako-Saito
authors.forename: Shun-Ichi
authors.initials: S
authors.lastname: Kimura
authors.forename: Misato
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakasone
authors.forename: Rie
authors.initials: R
authors.lastname: Yamazaki
authors.forename: Junya
authors.initials: J
authors.lastname: Kanda
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kako
authors.forename: Aki
authors.initials: A
authors.lastname: Tanihara
authors.forename: Junji
authors.initials: J
authors.lastname: Nishida
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006561:Herpes Simplex / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D006562:Herpes Zoster / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011292:Premedication; D012189:Retrospective Studies; D012307:Risk Factors; D019172:Transplantation Conditioning / Q000009:adverse effects; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir