Clinical Hematology International

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Volume 1, Issue 2, June 2019, Pages 101 - 104

Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

Authors
Naomi Fei1, *, Nilay Shah2, Aaron Cumpston2, 3, Sijin Wen4, Kelly G. Ross2, Michael Craig2, Abraham S. Kanate2
1Section of Hematology and Oncology, West Virginia University, Morgantown, WV, USA
2Alexander B. Osborn Hematopoietic Malignancy and Cellular Therapy Program, West Virginia University, Morgantown, WV, USA
3Department of Pharmacy, West Virginia University Hospitals, Morgantown, WV, USA
4Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
*Corresponding author. 4th Floor HSCN Rm 4071, 1 Medical Center Drive, Morgantown West Virginia. Phone: 304-282-0165, Email: nhfei@hsc.wvu.edu
Corresponding Author
Naomi Fei
Received 17 February 2019, Accepted 28 March 2019, Available Online 11 June 2019.
DOI
10.2991/chi.d.190329.001How to use a DOI?
Keywords
Autologous hematopoietic cell transplantation; Varicella zoster virus; Acyclovir; Valacyclovir
Abstract

Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for at least one-year post-HCT, with continued use recommended in immunosuppressed recipients. Acyclovir dosing regimens vary between institutions despite the noted recommendations. In this single-center, retrospective study, recipients of auto-HCT who received at least one year of low-dose antiviral prophylaxis defined as the equivalent of acyclovir 400 mg orally twice daily or valacyclovir 500 mg daily were included. The primary objective of this study was to assess the incidence of VZV reactivation with low-dose acyclovir/valacyclovir prophylaxis in autograft recipients. One hundred and eighty patients undergoing auto-HCT between April 2008 and March 2015 were included. Patients received low-dose acyclovir, for a median duration of 55.5 months (range 12–100). There were no occurrences of VZV reactivation while patients were on these drugs. However, 2 patients (1.1%) had VZV reactivation after discontinuation of therapy, occurring 18.8 and 14 months from transplant and 6.7 and 2 months after stopping prophylaxis, respectively. Our retrospective analysis found low-dose antiviral prophylaxis with oral acyclovir 400 mg twice daily or valacyclovir 500 mg daily to be effective in preventing VZV reactivation in auto-HCT recipients.

Copyright
© 2019 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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<Previous Article In Issue
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Journal
Clinical Hematology International
Volume-Issue
1 - 2
Pages
101 - 104
Publication Date
2019/06/11
ISSN (Online)
2590-0048
DOI
10.2991/chi.d.190329.001How to use a DOI?
Copyright
© 2019 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

risenwbib
TY  - JOUR
AU  - Naomi Fei
AU  - Nilay Shah
AU  - Aaron Cumpston
AU  - Sijin Wen
AU  - Kelly G. Ross
AU  - Michael Craig
AU  - Abraham S. Kanate
PY  - 2019
DA  - 2019/06/11
TI  - Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients
JO  - Clinical Hematology International
SP  - 101
EP  - 104
VL  - 1
IS  - 2
SN  - 2590-0048
UR  - https://doi.org/10.2991/chi.d.190329.001
DO  - 10.2991/chi.d.190329.001
ID  - Fei2019
ER  -