Clinical study on varicella zoster virus infection in children following allogeneic hematopoietic stem cell transplantation
10.3760/cma.j.issn.2095-428X.2019.12.012
- VernacularTitle: 异基因造血干细胞移植术后患儿带状疱疹病毒感染的临床研究
- Author:
Zhuo WANG
1
;
Yuelin HE
2
;
Jianyun LIAO
2
;
Chunfu LI
2
Author Information
1. Department of Hematology and Oncology, Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430015, China
2. Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
- Publication Type:Journal Article
- Keywords:
Varicella zoster virus;
Allogeneic Hematopoietic stem cell transplantation;
Child;
Prophylaxis
- From:
Chinese Journal of Applied Clinical Pediatrics
2019;34(12):930-933
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors of varicella zoster virus(VZV) infection after allogeneic hematopoietic stem cell transplantation(allo-HSCT) in children, and to provide reference for the diagnosis, monitoring and prophylaxis of VZV infection after allo-HSCT.
Methods:A total of 367 patients, who underwent allo-HSCT in Pediatric Transplantation Center of Nanfang Hospital Affiliated to Southern Medical University from January 2012 to June 2015 were collected.Clinical characteristics and risk factors of the patients complicated with VZV after allo-HSCT were retrospectively analyzed.
Results:Thirty-four patients (9.26%) were complicated with VZV infection after allo-HSCT.The median onset time was 96.5 d(19-326 d). Two of 34 patients relapsed 3 times, 1 case of them relapsed twice, 3 cases of them relapsed once, and 4 cases of 34 patients were complicated with VZV encephalitis.All cases were treated with antivirus drugs, infusion of immunoglobulin, reduction of immunosuppressant dosages, with external use of Acyclovir ointment.The median therapy time was 13 days (7-28 days). All of their herpes subsided, and neurological symptoms such as headache, vomiting and convulsion disappeared.VZV-DNA both in blood and cerebrospinal fluid turned negative.No patient had herpetic dissemination and visceral involvement, and no one died directly of VZV infection.Results indicated that age(χ2=6.863, P=0.009), underlying disease(χ2=14.793, P=0.022), type of HSCT(χ2=14.459, P=0.001) and resource of stem cell (χ2=20.585, P=0.002) were significant risk factors for VZV infection after allo-HSCT, while sex (χ2=0.106, P=0.745) and antithymocyte globulin in conditioning regimen(χ2=0.010, P=0.921) had no relation to it.
Conclusions:VZV infection mainly occur within 12 months after allo-HSCT and is prone to be complicated with VZV encephalitis.The effect of Acyclovir is good.Monitoring and prophylaxis of VZV infection after allo-HSCT should be strengthened in children with high risk factors.
