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One-year low-dose valacyclovir as prophylaxis for varicella zoster virus disease after allogeneic hematopoietic stem cell transplantation. A prospective study of the Japan Hematology and Oncology Clinical Study Group

2010; Wiley; Volume: 12; Issue: 5 Linguagem: Inglês

10.1111/j.1399-3062.2010.00541.x

1399-3062

Kiyohiro Oshima, Tohru Takahashi, Takehiko Mori, T Matsuyama, Kensuke Usuki, Yuki Asano‐Mori, Fumio Nakahara, Shigefumi OKAMOTO, Mineo Kurokawa, Yoshinobu Kanda,

Virus-based gene therapy research

K. Oshima, T. Takahashi, T. Mori, T. Matsuyama, K. Usuki, Y. Asano-Mori, F. Nakahara, S. Okamoto, M. Kurokawa, Y. Kanda. One-year low-dose valacyclovir as prophylaxis for varicella zoster virus disease after allogeneic hematopoietic stem cell transplantation. A prospective study of the Japan Hematology and Oncology Clinical Study GroupTranspl Infect Dis 2010: 12: 421–427. All rights reserved Abstract: Varicella zoster virus (VZV) disease is a frequent complication after allogeneic hematopoietic stem cell transplantation (HSCT). We carried out a trial of 1-year low-dose valacyclovir (VCV) prophylaxis against VZV disease to evaluate its efficacy and safety. Patients received oral acyclovir (ACV) 1000 mg/day until day 35 after HSCT. Oral VCV 500 mg/day, 3 times a week, was started on day 36 and continued until 1 year after HSCT. The development of VZV disease was monitored until 2 years after HSCT. A total of 40 patients with a median age of 43 years were enrolled. VCV was well tolerated in all but 1 patient who discontinued it on day 224 because of thrombocytopenia of unknown cause. Seven patients developed VZV disease at a median of 479 days (range 145–651) after HSCT, with a cumulative incidence of 18.5%. Two patients developed breakthrough disease during VCV prophylaxis. The other 5 patients developed VZV disease after the discontinuation of VCV, and 3 of these had developed extensive chronic graft-versus-host disease. Visceral involvement and serious complications were completely eliminated. All patients responded to the therapeutic dose of VCV or ACV. One-year low-dose VCV can be safely and effectively administered for the prevention of VZV disease after allogeneic HSCT.