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KMID : 0857020100250010020
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Kosin Medical Journal
2010 Volume.25 No. 1 p.20 ~ p.26
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Herpesviridae Viral Infectious Following Stem Cell Transplantation in Hematologic Malignancy
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Lee Ho-Sup
Tag Hee-Sang
Shin Seong-Hoon
Kim Yang-Soo
Nam Seong-Jin
Kim Hye-Soo
Park Jin-Hee
Jeong Su-Hyeon
Kim Sung-Bin
Kim Ye-Na
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Abstract
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Background : Herpesviridae family includes herpes simplex virus, varicella zoster virus, Epstein-Barr virus, and
cytomegalovirus, etc. Herpesviridae viral infection (HVI) can lead to serious complications including dissemination,
secondary infection, bacterial superinfection in patients with hematologic malignancy following hematopoietic stem cell
transplantation (HSCT). But there was no consensus on the dose and duration of antiviral agents prophylaxis in patients
undergoing chemotherapy. We retrospectively analyzed the incidence and the risk factors for HVI.
Method : A total of 58 patients who newly diagnosed and received HSCT with prophylaxis of acyclovir at the Kosin
University Gospel Hospital, Busan, Korea between June 1995 and February 2009 were enrolled retrospectively in the
current study. HVI was confirmed based on clinical diagnosis, serologic test or pathologic diagnosis. The characteristics
of the patients were as follows: the median age was 44 years (range 19-62 years) with a female-to-male ratio of 30:28.
The enrolled diseases included leukemia (n=9, 15.5%), lymphoma (n=30, 51.7%), multiple myeloma (n=12, 20.7%),
aplastic anemia (n=6, 10.3%) and myelodysplastic syndrome (n=1, 1.7%). The results were analyzed using a chi-square
test and independent samples T test. For the multivariate analysis, we used logistic regression test.
Results : Fifteen patients (25.9%) developed HVI after HSCT. The cumulative incidence of HVI was 53.8% at 5 years
after HSCT. In univariate analysis, there was no significant risk factor for HVI. The presence of graft-versus-host
disease (GVHD) (37.5% in developed GVHD vs. 0% in no GVHD, p=0.200), duration of immunosuppressive therapy
(IST) in allo-SCT (15.98 ± 14.02 months vs. 6.78 ± 3.67 months, p = 0.374) were not risk factors for HVI.
Conclusion : The incidence of HVI was similar to that in historical other studies. There was no risk factor associated
with development of HVI. Most of the HVI occurred within the first 24 months after transplantation. So long term
use of antiviral prophylaxis may be needed to prevention of HVI after HSCT.
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KEYWORD
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hematologic malignancy, herpesviridaeviral infection, HSCT
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