THE TROUBLE THAT HEMATOLOGISTS DEALING WITH: VARICELLA-ZOSTER AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION
(Abstract release date: 05/19/16)
EHA Library. Comert Ozkan M. 06/09/16; 135082; PB2182
Dr. Melda Comert Ozkan
Contributions
Contributions
Abstract
Abstract: PB2182
Type: Publication Only
Background
Reactivation of varicella zoster virus (VZV) is a common event in patients undergoing allogeneic and autologous bone marrow transplantation (BMT).
Aims
The morbidity associated with VZV reactivation and post-herpetic neuralgia results in an impairment of the quality of life, which may also lead to an increase in transplantation related costs and hospitalization. Determining the risk factors for VZV reactivation was aimed.
Methods
We retrospectively analyzed the incidence, clinical outcome, and risk factors for VZV infections in 237 adult patients undergoing BMT between Jan 2011 and Feb 2016 in Inonu University Bone Marrow Transplantation Unit. All of the patients were treated with acyclovir prophylaxis for 3 months after the allogeneic BMT and 30 days for autologous BMT.
Results
Fourteen (5.9%) of the patients developed VZV reactivation. Five (35.7%) of them were autologous BMT and 9 (64.3%) were allogeneic BMT patients. All of the patients were presented with pain and dermatomal zoster. A median day of VZV was 413 days (range 63-820) after transplantation for autologous BMT and 302 days (range 61-1140) for allogeneic BMT. Twenty-one percent (n=3) of VZV reactivation occurred in the first 100 days and 14% (n=2) after the first 24 months. Six (66.6%) of allogeneic BMT patients were under immunsupressive treatment (cyclosporine ± mikofenolat mofetil) and 1 (11.1%) had lymphocytopenia when VZV was clinically detected. Sixty-six percent (n=6) of patients with VZV who were treated with allogeneic BMT were acute myeloid leukemia patients. Sixty-four percent (n=9) of the cases was presented in January-march peirod. The most frequent complication was post-herpetic neuralgia. There was no statistically significant difference between the type of hematologic diseases, type of transplantation and lymphocyte count through VZV reactivation. But season of the year (winter) revealed statistically significant difference in VZV reactivation. (p<0.05)
Conclusion
VZV reactivation rates of our BMT unit is significantly lower than the literature especially in autologous BMT. But winter season was defined as an risk factor for VZV reactivation. Longer acyclovir phrophylaxis after autologous BMT and additional phrophylaxis programme for winter months for 2 years after the BMT can be an effective strategy for VZV prevention. Another important key point can be the CD4/CD8 evaluation. Acyclovir phrophylaxis can be maneaged with CD4/CD8 numbers. Phrophylaxis can be continued until the normal CD4/CD8 values.
Session topic: E-poster
Keyword(s): Stem cell transplant
Type: Publication Only
Background
Reactivation of varicella zoster virus (VZV) is a common event in patients undergoing allogeneic and autologous bone marrow transplantation (BMT).
Aims
The morbidity associated with VZV reactivation and post-herpetic neuralgia results in an impairment of the quality of life, which may also lead to an increase in transplantation related costs and hospitalization. Determining the risk factors for VZV reactivation was aimed.
Methods
We retrospectively analyzed the incidence, clinical outcome, and risk factors for VZV infections in 237 adult patients undergoing BMT between Jan 2011 and Feb 2016 in Inonu University Bone Marrow Transplantation Unit. All of the patients were treated with acyclovir prophylaxis for 3 months after the allogeneic BMT and 30 days for autologous BMT.
Results
Fourteen (5.9%) of the patients developed VZV reactivation. Five (35.7%) of them were autologous BMT and 9 (64.3%) were allogeneic BMT patients. All of the patients were presented with pain and dermatomal zoster. A median day of VZV was 413 days (range 63-820) after transplantation for autologous BMT and 302 days (range 61-1140) for allogeneic BMT. Twenty-one percent (n=3) of VZV reactivation occurred in the first 100 days and 14% (n=2) after the first 24 months. Six (66.6%) of allogeneic BMT patients were under immunsupressive treatment (cyclosporine ± mikofenolat mofetil) and 1 (11.1%) had lymphocytopenia when VZV was clinically detected. Sixty-six percent (n=6) of patients with VZV who were treated with allogeneic BMT were acute myeloid leukemia patients. Sixty-four percent (n=9) of the cases was presented in January-march peirod. The most frequent complication was post-herpetic neuralgia. There was no statistically significant difference between the type of hematologic diseases, type of transplantation and lymphocyte count through VZV reactivation. But season of the year (winter) revealed statistically significant difference in VZV reactivation. (p<0.05)
Conclusion
VZV reactivation rates of our BMT unit is significantly lower than the literature especially in autologous BMT. But winter season was defined as an risk factor for VZV reactivation. Longer acyclovir phrophylaxis after autologous BMT and additional phrophylaxis programme for winter months for 2 years after the BMT can be an effective strategy for VZV prevention. Another important key point can be the CD4/CD8 evaluation. Acyclovir phrophylaxis can be maneaged with CD4/CD8 numbers. Phrophylaxis can be continued until the normal CD4/CD8 values.
Session topic: E-poster
Keyword(s): Stem cell transplant
Abstract: PB2182
Type: Publication Only
Background
Reactivation of varicella zoster virus (VZV) is a common event in patients undergoing allogeneic and autologous bone marrow transplantation (BMT).
Aims
The morbidity associated with VZV reactivation and post-herpetic neuralgia results in an impairment of the quality of life, which may also lead to an increase in transplantation related costs and hospitalization. Determining the risk factors for VZV reactivation was aimed.
Methods
We retrospectively analyzed the incidence, clinical outcome, and risk factors for VZV infections in 237 adult patients undergoing BMT between Jan 2011 and Feb 2016 in Inonu University Bone Marrow Transplantation Unit. All of the patients were treated with acyclovir prophylaxis for 3 months after the allogeneic BMT and 30 days for autologous BMT.
Results
Fourteen (5.9%) of the patients developed VZV reactivation. Five (35.7%) of them were autologous BMT and 9 (64.3%) were allogeneic BMT patients. All of the patients were presented with pain and dermatomal zoster. A median day of VZV was 413 days (range 63-820) after transplantation for autologous BMT and 302 days (range 61-1140) for allogeneic BMT. Twenty-one percent (n=3) of VZV reactivation occurred in the first 100 days and 14% (n=2) after the first 24 months. Six (66.6%) of allogeneic BMT patients were under immunsupressive treatment (cyclosporine ± mikofenolat mofetil) and 1 (11.1%) had lymphocytopenia when VZV was clinically detected. Sixty-six percent (n=6) of patients with VZV who were treated with allogeneic BMT were acute myeloid leukemia patients. Sixty-four percent (n=9) of the cases was presented in January-march peirod. The most frequent complication was post-herpetic neuralgia. There was no statistically significant difference between the type of hematologic diseases, type of transplantation and lymphocyte count through VZV reactivation. But season of the year (winter) revealed statistically significant difference in VZV reactivation. (p<0.05)
Conclusion
VZV reactivation rates of our BMT unit is significantly lower than the literature especially in autologous BMT. But winter season was defined as an risk factor for VZV reactivation. Longer acyclovir phrophylaxis after autologous BMT and additional phrophylaxis programme for winter months for 2 years after the BMT can be an effective strategy for VZV prevention. Another important key point can be the CD4/CD8 evaluation. Acyclovir phrophylaxis can be maneaged with CD4/CD8 numbers. Phrophylaxis can be continued until the normal CD4/CD8 values.
Session topic: E-poster
Keyword(s): Stem cell transplant
Type: Publication Only
Background
Reactivation of varicella zoster virus (VZV) is a common event in patients undergoing allogeneic and autologous bone marrow transplantation (BMT).
Aims
The morbidity associated with VZV reactivation and post-herpetic neuralgia results in an impairment of the quality of life, which may also lead to an increase in transplantation related costs and hospitalization. Determining the risk factors for VZV reactivation was aimed.
Methods
We retrospectively analyzed the incidence, clinical outcome, and risk factors for VZV infections in 237 adult patients undergoing BMT between Jan 2011 and Feb 2016 in Inonu University Bone Marrow Transplantation Unit. All of the patients were treated with acyclovir prophylaxis for 3 months after the allogeneic BMT and 30 days for autologous BMT.
Results
Fourteen (5.9%) of the patients developed VZV reactivation. Five (35.7%) of them were autologous BMT and 9 (64.3%) were allogeneic BMT patients. All of the patients were presented with pain and dermatomal zoster. A median day of VZV was 413 days (range 63-820) after transplantation for autologous BMT and 302 days (range 61-1140) for allogeneic BMT. Twenty-one percent (n=3) of VZV reactivation occurred in the first 100 days and 14% (n=2) after the first 24 months. Six (66.6%) of allogeneic BMT patients were under immunsupressive treatment (cyclosporine ± mikofenolat mofetil) and 1 (11.1%) had lymphocytopenia when VZV was clinically detected. Sixty-six percent (n=6) of patients with VZV who were treated with allogeneic BMT were acute myeloid leukemia patients. Sixty-four percent (n=9) of the cases was presented in January-march peirod. The most frequent complication was post-herpetic neuralgia. There was no statistically significant difference between the type of hematologic diseases, type of transplantation and lymphocyte count through VZV reactivation. But season of the year (winter) revealed statistically significant difference in VZV reactivation. (p<0.05)
Conclusion
VZV reactivation rates of our BMT unit is significantly lower than the literature especially in autologous BMT. But winter season was defined as an risk factor for VZV reactivation. Longer acyclovir phrophylaxis after autologous BMT and additional phrophylaxis programme for winter months for 2 years after the BMT can be an effective strategy for VZV prevention. Another important key point can be the CD4/CD8 evaluation. Acyclovir phrophylaxis can be maneaged with CD4/CD8 numbers. Phrophylaxis can be continued until the normal CD4/CD8 values.
Session topic: E-poster
Keyword(s): Stem cell transplant
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