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

Y. Kanda, S. Mineishi, T. Saito, A. Saito, S. Yamada, M. Ohnishi, A. Chizuka, H. Niiya, K. Suenaga, K. Nakai, T. Takeuchi, A. Makimoto, Ryuji Tanosaki, M. Kami, Y. Tanaka, S. Fujita, T. Watanabe, Y. Kobayashi, K. Tobinai, Y. Takaue

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

To evaluate the efficacy of long-term administration of acyclovir as prophylaxis against varicella-zoster virus (VZV) reactivation, we analyzed the medical records of 86 consecutive adult patients who obtained engraftment after allogeneic hematopoietic stem cell transplantation from January 1996 to March 2000. We started long-term low-dose (400 mg/day) oral administration of acyclovir in June 1999, and this was continued until the end of immunosuppressive therapy after transplantation. There was no breakthrough reactivation of VZV in patients receiving acyclovir. Five patients who were receiving cyclosporine or prednisolone developed VZV reactivation after discontinuing acyclovir. With this prophylaxis, the cumulative incidence of VZV reactivation 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 reactivation. These findings suggest the efficacy of long-term prophylaxis with low-dose acyclovir. Resumption of acyclovir upon restarting immunosuppressive therapy might be important for the further prevention of VZV reactivation. The benefit of long-term low-dose acyclovir should be confirmed prospectively.

Original languageEnglish
Pages (from-to)689-692
Number of pages4
JournalBone Marrow Transplantation
Volume28
Issue number7
DOIs
Publication statusPublished - 2001
Externally publishedYes

Fingerprint

Human Herpesvirus 3
Acyclovir
Hematopoietic Stem Cell Transplantation
Immunosuppressive Agents
Transplantation
Prednisolone
Cyclosporine
Medical Records
Oral Administration
Multivariate Analysis
Incidence
Therapeutics

Keywords

  • Acyclovir
  • Hematopoietic stem cell transplantation
  • Prophylaxis
  • Varicella-zoster virus

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Long-term low-dose acyclovir against varicella-zoster virus reactivation after allogeneic hematopoietic stem cell transplantation. / Kanda, Y.; Mineishi, S.; Saito, T.; Saito, A.; Yamada, S.; Ohnishi, M.; Chizuka, A.; Niiya, H.; Suenaga, K.; Nakai, K.; Takeuchi, T.; Makimoto, A.; Tanosaki, Ryuji; Kami, M.; Tanaka, Y.; Fujita, S.; Watanabe, T.; Kobayashi, Y.; Tobinai, K.; Takaue, Y.

In: Bone Marrow Transplantation, Vol. 28, No. 7, 2001, p. 689-692.

Research output: Contribution to journalArticle

Kanda, Y, Mineishi, S, Saito, T, Saito, A, Yamada, S, Ohnishi, M, Chizuka, A, Niiya, H, Suenaga, K, Nakai, K, Takeuchi, T, Makimoto, A, Tanosaki, R, Kami, M, Tanaka, Y, Fujita, S, Watanabe, T, Kobayashi, Y, Tobinai, K & Takaue, Y 2001, 'Long-term low-dose acyclovir against varicella-zoster virus reactivation after allogeneic hematopoietic stem cell transplantation', Bone Marrow Transplantation, vol. 28, no. 7, pp. 689-692. https://doi.org/10.1038/sj.bmt.1703214
Kanda, Y. ; Mineishi, S. ; Saito, T. ; Saito, A. ; Yamada, S. ; Ohnishi, M. ; Chizuka, A. ; Niiya, H. ; Suenaga, K. ; Nakai, K. ; Takeuchi, T. ; Makimoto, A. ; Tanosaki, Ryuji ; Kami, M. ; Tanaka, Y. ; Fujita, S. ; Watanabe, T. ; Kobayashi, Y. ; Tobinai, K. ; Takaue, Y. / Long-term low-dose acyclovir against varicella-zoster virus reactivation after allogeneic hematopoietic stem cell transplantation. In: Bone Marrow Transplantation. 2001 ; Vol. 28, No. 7. pp. 689-692.
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T1 - Long-term low-dose acyclovir against varicella-zoster virus reactivation after allogeneic hematopoietic stem cell transplantation

AU - Kanda, Y.

AU - Mineishi, S.

AU - Saito, T.

AU - Saito, A.

AU - Yamada, S.

AU - Ohnishi, M.

AU - Chizuka, A.

AU - Niiya, H.

AU - Suenaga, K.

AU - Nakai, K.

AU - Takeuchi, T.

AU - Makimoto, A.

AU - Tanosaki, Ryuji

AU - Kami, M.

AU - Tanaka, Y.

AU - Fujita, S.

AU - Watanabe, T.

AU - Kobayashi, Y.

AU - Tobinai, K.

AU - Takaue, Y.

PY - 2001

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AB - To evaluate the efficacy of long-term administration of acyclovir as prophylaxis against varicella-zoster virus (VZV) reactivation, we analyzed the medical records of 86 consecutive adult patients who obtained engraftment after allogeneic hematopoietic stem cell transplantation from January 1996 to March 2000. We started long-term low-dose (400 mg/day) oral administration of acyclovir in June 1999, and this was continued until the end of immunosuppressive therapy after transplantation. There was no breakthrough reactivation of VZV in patients receiving acyclovir. Five patients who were receiving cyclosporine or prednisolone developed VZV reactivation after discontinuing acyclovir. With this prophylaxis, the cumulative incidence of VZV reactivation 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 reactivation. These findings suggest the efficacy of long-term prophylaxis with low-dose acyclovir. Resumption of acyclovir upon restarting immunosuppressive therapy might be important for the further prevention of VZV reactivation. The benefit of long-term low-dose acyclovir should be confirmed prospectively.

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