Long-term low-dose acyclovir against varicella-zoster virus reactivation after allogeneic hematopoietic stem cell transplantation

Citation
Y. Kanda et al., Long-term low-dose acyclovir against varicella-zoster virus reactivation after allogeneic hematopoietic stem cell transplantation, BONE MAR TR, 28(7), 2001, pp. 689-692
Citations number
13
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology,"Medical Research Diagnosis & Treatment
Journal title
BONE MARROW TRANSPLANTATION
ISSN journal
0268-3369 → ACNP
Volume
28
Issue
7
Year of publication
2001
Pages
689 - 692
Database
ISI
SICI code
0268-3369(200110)28:7<689:LLAAVV>2.0.ZU;2-9
Abstract
To evaluate the efficacy of long-term administration of acyclovir as prophy laxis against varicella-zoster virus (VZV) reactivation, we analyzed the me dical records of 86 consecutive adult patients who obtained engraftment aft er allogeneic hematopoietic stem cell transplantation from January 1996 to March 2000. We started longterm low-dose (400 mg/day) oral administration o f acyclovir in June 1999, and this was continued until the end of immunosup pressive therapy after transplantation. There was no breakthrough reactivat ion of VZV in patients receiving acyclovir. Five patients who were receivin g cyclosporine or prednisolone developed VZV reactivation after discontinui ng acyclovir. With this prophylaxis, the cumulative incidence of VZV reacti vation at 1 year after transplantation decreased from 33% to 10% (P = 0.025 ). On multivariate analysis, the use of long-term acyclovir was identified as a significant independent parameter for the development of VZV reactivat ion. These findings suggest the efficacy of longterm prophylaxis with low-d ose acyclovir. Resumption of acyclovir upon restarting immunosuppressive th erapy might be important for the further prevention of VZV reactivation. Th e benefit of long-term low-dose acyclovir should be confirmed prospectively .