Kawamura Koji, Hayakawa Jin, Akahoshi Yu, Harada Naonori, Nakano Hirofumi, Kameda Kazuaki, Ugai Tomotaka, Wada Hidenori, Yamasaki Ryoko, Ishihara Yuko, Sakamoto Kana, Ashizawa Masahiro, Sato Miki, Terasako-Saito Kiriko, Kimura Shun-Ichi, Kikuchi Misato, Nakasone Hideki, Yamazaki Rie, Kanda Junya, Kako Shinichi, Tanihara Aki, Nishida Junji, Kanda Yoshinobu
Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma-cho, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
Int J Hematol. 2015 Aug;102(2):230-7. doi: 10.1007/s12185-015-1810-4. Epub 2015 May 20.
Limited data are available on prophylaxis for herpes simplex virus (HSV) and varicella zoster virus (VZV) disease following autologous hematopoietic stem cell transplantation (auto-HCT). We retrospectively reviewed the clinical charts of 105 consecutive patients who underwent their first auto-HCT at our institution between September 2007 and June 2014. Before August 2009, 30 patients received oral acyclovir at 1000 mg/day until engraftment, whereas after September 2009, 69 patients received oral acyclovir at 200 mg/day. After engraftment, acyclovir was continued at 200 mg/day at the discretion of the attending physicians in both groups. The cumulative incidence of HSV disease at 1 year after auto-HCT was 7.7 and 4.5 % in patients who received oral acyclovir at 1000 and 200 mg/day, respectively (P = 0.75). Patients were next divided into three groups according to the timing at which acyclovir prophylaxis was stopped after auto-HCT; at engraftment, between engraftment and 1 year after auto-HCT, and later than 1 year. The cumulative incidence of VZV disease was 25.8, 7.7, and 0.0 % at 1 year, respectively. This study suggests that low-dose acyclovir prophylaxis may be effective for preventing HSV and VZV disease after auto-HCT. Our findings support the recommendation of acyclovir prophylaxis within the first year after auto-HCT.
关于自体造血干细胞移植（auto-HCT）后单纯疱疹病毒（HSV）和水痘带状疱疹病毒（VZV）疾病预防的可用数据有限。我们回顾性分析了2007年9月至2014年6月期间在我院接受首次auto-HCT的105例连续患者的临床病历。2009年8月之前，30例患者接受每日1000毫克口服阿昔洛韦直至植入，而2009年9月之后，69例患者接受每日200毫克口服阿昔洛韦。植入后，两组的主治医生可自行决定继续给予每日200毫克阿昔洛韦。接受每日1000毫克和200毫克口服阿昔洛韦的患者在auto-HCT后1年时HSV疾病的累积发生率分别为7.7%和4.5%（P = 0.75）。接下来，根据auto-HCT后停用阿昔洛韦预防的时间将患者分为三组；在植入时、植入后至auto-HCT后1年之间以及1年之后。VZV疾病在1年时的累积发生率分别为25.8%、7.7%和0.0%。本研究表明，低剂量阿昔洛韦预防可能对预防auto-HCT后的HSV和VZV疾病有效。我们的研究结果支持在auto-HCT后第一年内进行阿昔洛韦预防的建议。
