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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 (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 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 Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted September 9, 2005 Accepted October 24, 2005 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 Flowers, Joel D Meyers, and Raleigh A Bowden Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA, USA * Corresponding author; email: mboeckh{at}fhcrc.org. VZV infection occurs in 30% of allogeneic hematopoietic cell transplant (HCT) 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 HCT recipients at risk for VZV reactivation were randomized to acyclovir 800 mg twice daily or placebo given from 1-2 months until 1 year after transplantation. VZV disease at one year was the primary endpoint; VZV disease after discontinuation of prophylaxis, VZV-specific T cell immunity, HSV infection, CMV disease, survival and safety were secondary endpoints. Acyclovir significantly reduced VZV disease at one year after transplantation (hazard ratio [HR] 0.16, 95% confidence interval 0.035-0.74, P=0.006). In the post-intervention 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 GvHD, 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 HCT. Periods of prophylaxis greater than 12 months may be beneficial for those HCT 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]

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