Noronha Vanita, Ostwal Vikas, Ramaswamy Anant, Joshi Amit, Nair Reena, Banavali Shripad D, Prabhash Kumar
Department of Medical Oncology, Tata Memorial Center, Parel, Mumbai, India.
Department of Medical Oncology, Tata Memorial Center, Parel, Mumbai, India.
J Infect Public Health. 2017 Jan-Feb;10(1):8-13. doi: 10.1016/j.jiph.2015.12.016. Epub 2016 Mar 9.
There is paucity of data on the incidence, severity and management of chicken pox in patients receiving active chemotherapy for cancer. From October 2010 to October 2011, patients were included in this study if they developed a chicken pox infection during their chemotherapy. The details of patients' cancer diagnosis and treatment along with clinical and epidemiological data of the chicken pox infections were assessed from a prospectively maintained database. Twenty-four patients had a chicken pox infection while receiving chemotherapy and/or radiotherapy. The median age of the patients was 21 years, and two-thirds of the patients had solid tumor malignancies. Overall, eight (33%) patients had complications, six (25%) patients had febrile neutropenia, four (17%) had diarrhea/mucositis, and four (17%) had pneumonia. The median time for recovery of the infection and complications in the patients was 9.5 days (5-29 days), whereas for neutropenic patients, it was 6.5 days (3-14 days). The median time for recovery from chicken pox infections in neutropenic patients was 10 days (5-21 days), compared with 8.5 days (0-29 days) in non-neutropenic patients (P=0.84). The median time for recovery from infections was 8.5 days in patients with comorbidities (N=4), which was the same for patients with no comorbidities. The clinical presentation and complication rates of chicken pox in cancer patients, who were on active chemotherapy, are similar to the normal population. The recovery from a varicella infection and complications may be delayed in patients with neutropenia. The varicella infection causes a therapy delay in 70% of patients. Aggressive antiviral therapy, supportive care and isolation of the index cases remain the backbone of treatment.
关于接受癌症积极化疗的患者中水痘的发病率、严重程度及治疗的数据较少。从2010年10月至2011年10月，若患者在化疗期间发生水痘感染，则纳入本研究。从一个前瞻性维护的数据库中评估患者癌症诊断和治疗的详细情况以及水痘感染的临床和流行病学数据。24例患者在接受化疗和/或放疗时发生了水痘感染。患者的中位年龄为21岁，三分之二的患者患有实体瘤恶性肿瘤。总体而言，8例（33%）患者出现并发症，6例（25%）患者出现发热性中性粒细胞减少，4例（17%）出现腹泻/黏膜炎，4例（17%）出现肺炎。患者感染及并发症恢复的中位时间为9.5天（5 - 29天），而中性粒细胞减少患者为6.5天（3 - 14天）。中性粒细胞减少患者水痘感染恢复的中位时间为10天（5 - 21天），非中性粒细胞减少患者为8.5天（0 - 29天）（P = 0.84）。合并症患者（N = 4）感染恢复的中位时间为8.5天，无合并症患者也是如此。正在接受积极化疗的癌症患者中水痘的临床表现和并发症发生率与正常人群相似。中性粒细胞减少患者水痘感染及并发症的恢复可能会延迟。水痘感染导致70%的患者治疗延迟。积极的抗病毒治疗、支持性护理及对索引病例的隔离仍是治疗的关键。
