Abstract
We report a retrospective analysis of VZV infection after haematopoietic stem cell transplantation (HSCT) in children. Thirty-three (30%) of the total 109 children who were transplanted during a 7 year period developed post-transplant VZV infection. Twenty-four of these 33 (73%) children had VZV infection within 1 year following HSCT. The cumulative incidences of post-transplant VZV infection at 1 and 5 years were 26% and 45%, respectively. The positive and negative predictive values of pretransplant VZV serology in recipients on the development of HZ following HSCT were 39% and 88%, respectively. Pretransplant VZV seropositivity in recipients was the only risk factor for post-transplant herpes zoster (HZ) infection on multivariate analysis. All patients responded to acyclovir. The median duration of VZV infection was 5 days. Three (11%) and one (3%) children with HZ developed visceral dissemination and post-herpetic neuralgia, respectively. No mortality was directly attributed to VZV infection. VZV infection remains a major cause of morbidity in children after HSCT. Further studies are warranted to evaluate the potential use of VZV vaccine in these children. Bone Marrow Transplantation (2000) 25, 167–172.
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References
Feldman S, Hughes W, Daniel C . Varicella in children with cancer: 77 cases Pediatrics 1975 80: 388–397
Kawasaki H, Takayama J, Ohira M . Herpes zoster infection after bone marrow transplantation in children J Pediatr 1996 128: 353–356
Nakayama H, Okamura J, Ohga S et al. Herpes zoster in children with bone marrow transplantation: report from a single institution Acta Paediatr Jpn 1995 37: 302–307
Sauerbrei A, Prager J, Hengst U et al. Varicella vaccination in children after bone marrow transplantation Bone Marrow Transplant 1997 20: 381–383
Wacker P, Hartmann O, Benhamou E et al. Varicella-zoster virus infections after autologous bone marrow transplantation in children Bone Marrow Transplant 1989 4: 191–194
Takaue Y, Okamoto Y, Kawano Y et al. Regeneration of immunity and varicella-zoster virus infection after high-dose chemotherapy and peripheral blood stem cell autografts in children Bone Marrow Transplant 1994 14: 219–223
Schuchter LM, Wingard JR, Piantadosi S et al. Herpes zoster infection after autologous bone marrow transplantation Blood 1989 74: 1424–1427
Shing MM, Yuen PM, Li CK et al. A more immunosuppressive pre-transplant conditioning may be required for Chinese patients with thalassaemia Bone Marrow Transplant 1996 17: 907–910
Li CK, Yuen PM, Chik KW et al. Allogeneic peripheral blood stem cell transplant in children Med Pediatr Oncol 1998 30: 147–151
Yuen PM, Chik KW, Li CK et al. Transplantation in childhood hematologic malignancies with closely matched family donors in Hong Kong Transplant Proc 1998 30: 3481–3483
Han CS, Miller W, Haake R, Weisdorf D . Varicella zoster infection after bone marrow transplantation: incidence, risk factors and complications Bone Marrow Transplant 1994 13: 277–283
Gratama JW, Verdonck LF, van der Linden JA et al. Cellular immunity to vaccinations and herpesvirus infections after bone marrow transplantation Transplantation 1986 41: 719–724
Novelli VM, Brunell PA, Geiser CF et al. Herpes zoster in children with acute lymphocytic leukaemia Am J Dis Child 1988 142: 71–72
Wilson A, Sharp M, Koropchak CM et al. Subclinical varicella-zoster virus viremia, herpes zoster, and T lymphocyte immunity to varicella-zoster viral antigens after bone marrow transplantation J Infect Dis 1992 165: 119–126
Ljungman P, Lonnqvist B, Gahrton G et al. Clinical and subclinical reactivations of varicella-zoster virus in immunocompromised patients J Infect Dis 1986 153: 840–847
Petursson G, Helgason S, Gudmundsson S, Sigurdsson JA . Herpes zoster in children and adolescents Pediatr Infect Dis J 1998 17: 905–908
Locksley RM, Flournoy N, Sullivan KM, Meyers JD . Infection with varicella-zoster virus after marrow transplantation J Infect Dis 1985 152: 1172–1181
Tzeng CH, Liu JH, Fan S et al. Varicella zoster virus infection after allogeneic or autologous hemopoietic stem cell transplantation J Formos Med Assoc 1995 94: 313–317
Callum JL, Brandwein JM, Sutcliffe SB et al. Influence of total body irradiation on infections after autologous bone marrow transplantation Bone Marrow Transplant 1991 8: 245–251
Meyers JD, Flournoy N, Thomas ED . Cell-mediated immunity to varicella-zoster virus after allogeneic marrow transplant J Infect Dis 1980 141: 479–487
Sempere A, Sanz GF, Senent L et al. Long-term acyclovir prophylaxis for prevention of varicella zoster virus infection after autologous blood stem cell transplantation in patients with acute leukemia Bone Marrow Transplant 1992 10: 495–498
Masaoka T, Hiraoka A, Teshima H, Tominaga N . Varicella-zoster virus infection in immunocompromised patients J Med Virol 1993 (Suppl.1) 82–84
Reusser P, Cordonnier C, Einsele H et al. European survey of herpesvirus resistance to antiviral drugs in bone marrow transplant recipients. Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation (EBMT) Bone Marrow Transplant 1996 17: 813–817
LaRussa P, Steinberg S, Gershon AA . Varicella vaccine for immunocompromised children: results of collaborative studies in the United States and Canada J Infect Dis 1996 174: (Suppl.3) S320–323
Buda K, Tubergen DG, Levin MJ . The frequency and consequences of varicella exposure and varicella infection in children receiving maintenance therapy for acute lymphoblastic leukemia J Pediatr Hematol Oncol 1996 18: 106–112
Redman RL, Nader S, Zerboni L et al. Early reconstitution of immunity and decreased severity of herpes zoster in bone marrow transplant recipients immunized with inactivated varicella vaccine J Infect Dis 1997 176: 578–585
Lawrence R, Gershon AA, Holzman R, Steinberg SP, NIAID Varicella Vaccine Collaborative Study Group . The risk of zoster after varicella vaccination in children with leukemia New Engl J Med 1988 318: 543–548
Acknowledgements
We would like to thank the Hong Kong Paediatric Bone Marrow Transplant Fund and Children Cancer Fund of the Chinese University of Hong Kong for supporting bone marrow transplants for our patients.
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Leung, T., Chik, K., Li, C. et al. Incidence, risk factors and outcome of varicella-zoster virus infection in children after haematopoietic stem cell transplantation. Bone Marrow Transplant 25, 167–172 (2000). https://doi.org/10.1038/sj.bmt.1702119
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DOI: https://doi.org/10.1038/sj.bmt.1702119
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