title: Antiviral prophylaxis in patients with solid tumours and haematological malignancies--update of the Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO).
abstract: Reactivation of viral infections is common in patients with solid tumour or haematological malignancy. Incidence and severity depend on the extent of cellular immunosuppression. Antiviral prophylaxis may be effective to prevent viral reactivation. In 2006, the Infectious Diseases Working Party of German Society for Hematology and Medical Oncology (DGHO) published guidelines for antiviral prophylaxis in these patient populations. Here, we present an update of these guidelines for patients with solid and haematological malignancies undergoing antineoplastic treatment but not allogeneic stem cell transplantation. Relevant literature for reactivation of different viruses (herpes simplex virus (HSV), varicella zoster virus (VZV), hepatitis B virus (HBV) and respiratory viruses) is discussed to provide evidence-based recommendations for clinicians taking care of this patient population. We recommend a risk-adapted approach with (val)acyclovir against HSV and VZV in patients treated with alemtuzumab, bortezomib or purine analogues. Seasonal vaccination against influenza is recommended for all patients with solid or haematological malignancies regardless of antineoplastic therapy. Hepatitis B screening is recommended in lymphoproliferative disorders, acute leukaemia, and breast cancer, and during treatment with monoclonal anti-B-cell antibodies, anthracyclines, steroids and in autologous stem cell transplantation. In those with a history of hepatitis B prophylactic lamivudine, entecavir or nucleotide analogues as adefovir are recommended to prevent reactivation.
authors.affiliation: Gemeinschaftspraxis für Hämatologie und Onkologie, Röntgenstr. 4, 82362, Weilheim, Germany, michael.sandherr@web.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Sandherr
authors.forename: Marcus
authors.initials: M
authors.lastname: Hentrich
authors.forename: Marie
authors.initials: M
authors.lastname: von Lilienfeld-Toal
authors.forename: Gero
authors.initials: G
authors.lastname: Massenkeil
authors.forename: Silke
authors.initials: S
authors.lastname: Neumann
authors.forename: Olaf
authors.initials: O
authors.lastname: Penack
authors.forename: Lena
authors.initials: L
authors.lastname: Biehl
authors.forename: Oliver A
authors.initials: OA
authors.lastname: Cornely
mesh_terms: D000208:Acute Disease; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D064592:Autografts; D001943:Breast Neoplasms / Q000628:therapy*; D005260:Female; D005858:Germany; D006405:Hematology; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008297:Male; D008495:Medical Oncology; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D033581:Stem Cell Transplantation; D014777:Virus Diseases / Q000517:prevention & control*
chemical_list: D000970:Antineoplastic Agents; D000998:Antiviral Agents