SEARCH:   Advanced

Blood, 1 March 2006, Vol. 107, No. 5, pp. 1800-1805. Prepublished online as a Blood First Edition Paper on November 10, 2005; DOI 10.1182/blood-2005-09-3624. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-09-3624v1 107/5/1800    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Boeckh, M. Articles by Bowden, R. A. Search for Related Content PubMed PubMed Citation Articles by Boeckh, M. Articles by Bowden, R. A. Related Collections Neoplasia Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Long-term acyclovir for prevention of varicella zoster virus disease after allogeneic hematopoietic cell transplantation—a randomized double-blind placebo-controlled study Michael Boeckh, Hyung W. Kim, Mary E. D. Flowers, Joel D. Meyers, and Raleigh A. Bowden From the Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA. Varicella-zoster virus (VZV) disease occurs in 30% of allogeneic hematopoietic cell transplant recipients who had a history of VZV infection. A safe and effective prevention strategy has not been established. In a double-blind controlled trial, 77 hematopoietic cell transplant recipients at risk for VZV reactivation were randomized to acyclovir 800 mg twice daily or placebo given from 1 to 2 months until 1 year after transplantation. VZV disease at 1 year was the primary end point; VZV disease after discontinuation of prophylaxis, VZV-specific T-cell immunity, herpes simplex virus (HSV) infection, cytomegalovirus (CMV) disease, survival, and safety were secondary end points. Acyclovir significantly reduced VZV infections at 1 year after transplantation (HR, 0.16; 95% CI, 0.035-0.74; P = .006). In the postintervention observation period, this difference was not statistically significant (2 years: HR, 0.52; 95% CI, 0.21-1.3; 5 years: HR, 0.76; 95% CI, 0.36-1.6). There was no statistically significant difference in reconstitution of VZV-specific T-helper cell responses, HSV infections, CMV disease, chronic graft-versus-host disease, and overall survival between the groups. Acyclovir was well tolerated. Post-study VZV disease predominantly occurred in patients with continued need for systemic immunosuppression. In conclusion, acyclovir effectively and safely prevents VZV disease during the first year after hematopoietic cell transplantation. Periods of prophylaxis longer than 12 months may be beneficial for those hematopoietic cell transplant recipients on continued immune suppression. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: V. Erard, K. A. Guthrie, C. Varley, J. Heugel, A. Wald, M. E. D. Flowers, L. Corey, and M. Boeckh One-year acyclovir prophylaxis for preventing varicella-zoster virus disease after hematopoietic cell transplantation: no evidence of rebound varicella-zoster virus disease after drug discontinuation Blood, October 15, 2007; 110(8): 3071 - 3077. [Abstract] [Full Text] [PDF] H. C. Fung, M. A. Higman, and K. van Besien Stem cell transplantation ASH Self-Assessment Program, January 1, 2007; 2007(1): 328 - 360. [Full Text] [PDF] J. C. Wade Viral Infections in Patients with Hematological Malignancies Hematology, January 1, 2006; 2006(1): 368 - 374. [Abstract] [Full Text] [PDF]

	Copyright © 2006 by American Society of Hematology         Online ISSN: 1528-0020