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
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
.