Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus disease after allogeneic hematopoietic stem cell transplantation

K. Kawamura, H. Wada, R. Yamasaki, Y. Ishihara, K. Sakamoto, M. Ashizawa, M. Sato, T. Machishima, K. Terasako, S. I. Kimura, M. Kikuchi, H. Nakasone, Rie Yamazaki, J. Kanda, S. Kako, A. Tanihara, J. Nishida, Y. Kanda

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Currently, acyclovir (ACV) at 1000 mg/day is widely used as prophylaxis in the early phase of hematopoietic stem cell transplant (HSCT) in Japan. However, low-dose ACV (200 mg/day) has been shown to prevent varicella zoster virus reactivation in the middle and late phases of HSCT. Methods: Therefore, in this study, we decreased the dose of ACV to 200 mg/day in the early phase after HSCT. We analyzed 93 consecutive herpes simplex virus (HSV)-seropositive patients who underwent allogeneic HSCT for the first time in our center between June 2007 and December 2011. Results: Before August 2009, 38 patients received oral ACV at 1000 mg/day (ACV1000) until day 35 after HSCT, whereas 55 patients received oral ACV at 200 mg/day (ACV200) after September 2009. We compared the cumulative incidence of HSV infection in the 2 groups. Oral ACV was changed to intravenous administration because of intolerance in 66% and 45% of the patients in the ACV1000 and ACV200 groups, respectively (P = 0.060). The probability of severe stomatitis (Bearman grade II-III) was 76% and 60% in the ACV1000 and ACV200 groups, respectively (P = 0.12). The number of patients who developed HSV disease before day 100 after HSCT was 0 in the ACV1000 group and 2 in the ACV200 group, with a cumulative incidence of 3.6% (P = 0.43). HSV disease in the latter 2 patients was limited to the lips and tongue and was successfully treated with ACV or valacyclovir at a treatment dose. Conclusion: ACV at 200 mg/day appeared to be effective for preventing HSV disease in the early phase after HSCT.

Original languageEnglish
Pages (from-to)457-465
Number of pages9
JournalTransplant Infectious Disease
Volume15
Issue number5
DOIs
Publication statusPublished - 2013 Oct 1
Externally publishedYes

Fingerprint

Acyclovir
Hematopoietic Stem Cell Transplantation
Virus Diseases
Simplexvirus
Hematopoietic Stem Cells
Transplants
valacyclovir
Stomatitis
Human Herpesvirus 3
Incidence
Lip
Tongue
Intravenous Administration
Japan

Keywords

  • Acyclovir
  • Allogeneic hematopoietic stem cell transplantation
  • Herpes simplex virus disease

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases
  • Medicine(all)

Cite this

Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus disease after allogeneic hematopoietic stem cell transplantation. / Kawamura, K.; Wada, H.; Yamasaki, R.; Ishihara, Y.; Sakamoto, K.; Ashizawa, M.; Sato, M.; Machishima, T.; Terasako, K.; Kimura, S. I.; Kikuchi, M.; Nakasone, H.; Yamazaki, Rie; Kanda, J.; Kako, S.; Tanihara, A.; Nishida, J.; Kanda, Y.

In: Transplant Infectious Disease, Vol. 15, No. 5, 01.10.2013, p. 457-465.

Research output: Contribution to journalArticle

Kawamura, K, Wada, H, Yamasaki, R, Ishihara, Y, Sakamoto, K, Ashizawa, M, Sato, M, Machishima, T, Terasako, K, Kimura, SI, Kikuchi, M, Nakasone, H, Yamazaki, R, Kanda, J, Kako, S, Tanihara, A, Nishida, J & Kanda, Y 2013, 'Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus disease after allogeneic hematopoietic stem cell transplantation', Transplant Infectious Disease, vol. 15, no. 5, pp. 457-465. https://doi.org/10.1111/tid.12118
Kawamura, K. ; Wada, H. ; Yamasaki, R. ; Ishihara, Y. ; Sakamoto, K. ; Ashizawa, M. ; Sato, M. ; Machishima, T. ; Terasako, K. ; Kimura, S. I. ; Kikuchi, M. ; Nakasone, H. ; Yamazaki, Rie ; Kanda, J. ; Kako, S. ; Tanihara, A. ; Nishida, J. ; Kanda, Y. / Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus disease after allogeneic hematopoietic stem cell transplantation. In: Transplant Infectious Disease. 2013 ; Vol. 15, No. 5. pp. 457-465.
@article{0b5c711b984341199cf7efef6d912b51,
title = "Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus disease after allogeneic hematopoietic stem cell transplantation",
abstract = "Background: Currently, acyclovir (ACV) at 1000 mg/day is widely used as prophylaxis in the early phase of hematopoietic stem cell transplant (HSCT) in Japan. However, low-dose ACV (200 mg/day) has been shown to prevent varicella zoster virus reactivation in the middle and late phases of HSCT. Methods: Therefore, in this study, we decreased the dose of ACV to 200 mg/day in the early phase after HSCT. We analyzed 93 consecutive herpes simplex virus (HSV)-seropositive patients who underwent allogeneic HSCT for the first time in our center between June 2007 and December 2011. Results: Before August 2009, 38 patients received oral ACV at 1000 mg/day (ACV1000) until day 35 after HSCT, whereas 55 patients received oral ACV at 200 mg/day (ACV200) after September 2009. We compared the cumulative incidence of HSV infection in the 2 groups. Oral ACV was changed to intravenous administration because of intolerance in 66{\%} and 45{\%} of the patients in the ACV1000 and ACV200 groups, respectively (P = 0.060). The probability of severe stomatitis (Bearman grade II-III) was 76{\%} and 60{\%} in the ACV1000 and ACV200 groups, respectively (P = 0.12). The number of patients who developed HSV disease before day 100 after HSCT was 0 in the ACV1000 group and 2 in the ACV200 group, with a cumulative incidence of 3.6{\%} (P = 0.43). HSV disease in the latter 2 patients was limited to the lips and tongue and was successfully treated with ACV or valacyclovir at a treatment dose. Conclusion: ACV at 200 mg/day appeared to be effective for preventing HSV disease in the early phase after HSCT.",
keywords = "Acyclovir, Allogeneic hematopoietic stem cell transplantation, Herpes simplex virus disease",
author = "K. Kawamura and H. Wada and R. Yamasaki and Y. Ishihara and K. Sakamoto and M. Ashizawa and M. Sato and T. Machishima and K. Terasako and Kimura, {S. I.} and M. Kikuchi and H. Nakasone and Rie Yamazaki and J. Kanda and S. Kako and A. Tanihara and J. Nishida and Y. Kanda",
year = "2013",
month = "10",
day = "1",
doi = "10.1111/tid.12118",
language = "English",
volume = "15",
pages = "457--465",
journal = "Transplant Infectious Disease",
issn = "1398-2273",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Low-dose acyclovir prophylaxis for the prevention of herpes simplex virus disease after allogeneic hematopoietic stem cell transplantation

AU - Kawamura, K.

AU - Wada, H.

AU - Yamasaki, R.

AU - Ishihara, Y.

AU - Sakamoto, K.

AU - Ashizawa, M.

AU - Sato, M.

AU - Machishima, T.

AU - Terasako, K.

AU - Kimura, S. I.

AU - Kikuchi, M.

AU - Nakasone, H.

AU - Yamazaki, Rie

AU - Kanda, J.

AU - Kako, S.

AU - Tanihara, A.

AU - Nishida, J.

AU - Kanda, Y.

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Background: Currently, acyclovir (ACV) at 1000 mg/day is widely used as prophylaxis in the early phase of hematopoietic stem cell transplant (HSCT) in Japan. However, low-dose ACV (200 mg/day) has been shown to prevent varicella zoster virus reactivation in the middle and late phases of HSCT. Methods: Therefore, in this study, we decreased the dose of ACV to 200 mg/day in the early phase after HSCT. We analyzed 93 consecutive herpes simplex virus (HSV)-seropositive patients who underwent allogeneic HSCT for the first time in our center between June 2007 and December 2011. Results: Before August 2009, 38 patients received oral ACV at 1000 mg/day (ACV1000) until day 35 after HSCT, whereas 55 patients received oral ACV at 200 mg/day (ACV200) after September 2009. We compared the cumulative incidence of HSV infection in the 2 groups. Oral ACV was changed to intravenous administration because of intolerance in 66% and 45% of the patients in the ACV1000 and ACV200 groups, respectively (P = 0.060). The probability of severe stomatitis (Bearman grade II-III) was 76% and 60% in the ACV1000 and ACV200 groups, respectively (P = 0.12). The number of patients who developed HSV disease before day 100 after HSCT was 0 in the ACV1000 group and 2 in the ACV200 group, with a cumulative incidence of 3.6% (P = 0.43). HSV disease in the latter 2 patients was limited to the lips and tongue and was successfully treated with ACV or valacyclovir at a treatment dose. Conclusion: ACV at 200 mg/day appeared to be effective for preventing HSV disease in the early phase after HSCT.

AB - Background: Currently, acyclovir (ACV) at 1000 mg/day is widely used as prophylaxis in the early phase of hematopoietic stem cell transplant (HSCT) in Japan. However, low-dose ACV (200 mg/day) has been shown to prevent varicella zoster virus reactivation in the middle and late phases of HSCT. Methods: Therefore, in this study, we decreased the dose of ACV to 200 mg/day in the early phase after HSCT. We analyzed 93 consecutive herpes simplex virus (HSV)-seropositive patients who underwent allogeneic HSCT for the first time in our center between June 2007 and December 2011. Results: Before August 2009, 38 patients received oral ACV at 1000 mg/day (ACV1000) until day 35 after HSCT, whereas 55 patients received oral ACV at 200 mg/day (ACV200) after September 2009. We compared the cumulative incidence of HSV infection in the 2 groups. Oral ACV was changed to intravenous administration because of intolerance in 66% and 45% of the patients in the ACV1000 and ACV200 groups, respectively (P = 0.060). The probability of severe stomatitis (Bearman grade II-III) was 76% and 60% in the ACV1000 and ACV200 groups, respectively (P = 0.12). The number of patients who developed HSV disease before day 100 after HSCT was 0 in the ACV1000 group and 2 in the ACV200 group, with a cumulative incidence of 3.6% (P = 0.43). HSV disease in the latter 2 patients was limited to the lips and tongue and was successfully treated with ACV or valacyclovir at a treatment dose. Conclusion: ACV at 200 mg/day appeared to be effective for preventing HSV disease in the early phase after HSCT.

KW - Acyclovir

KW - Allogeneic hematopoietic stem cell transplantation

KW - Herpes simplex virus disease

UR - http://www.scopus.com/inward/record.url?scp=84884977721&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884977721&partnerID=8YFLogxK

U2 - 10.1111/tid.12118

DO - 10.1111/tid.12118

M3 - Article

C2 - 23895431

AN - SCOPUS:84884977721

VL - 15

SP - 457

EP - 465

JO - Transplant Infectious Disease

JF - Transplant Infectious Disease

SN - 1398-2273

IS - 5

ER -