遵循多发性骨髓瘤中预防水痘-带状疱疹病毒再激活指南的重要性。
Importance of Compliance With Guidelines for the Prevention of Varicella-Zoster Virus Reactivation in Multiple Myeloma.
作者信息
Ohashi Yasukata, Yatabe Megumi, Niijima Daisuke, Imamura Arina, Nagayama Yoshiyuki, Otsuka Kentaro, Yachi Yutaka, Ueno Hironori, Yano Takahiro, Mori Nobuaki, Higai Koji, Yokoyama Akihiro
机构信息
Department of Pharmacy, National Hospital Organization Tokyo Medical Center, Tokyo, Japan;
Department of Medical Biochemistry, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan.
出版信息
In Vivo. 2021 Nov-Dec;35(6):3289-3296. doi: 10.21873/invivo.12624.
BACKGROUND/AIM: The importance of compliance with National Comprehensive Cancer Network (NCCN) guidelines for preventing varicella-zoster virus reactivation (VZVr) in multiple myeloma (MM) in a clinical setting has not been well investigated.
PATIENTS AND METHODS
We retrospectively studied the clinical characteristics and outcomes of 118 patients with MM treated with proteasome inhibitors.
RESULTS
Thirty-nine episodes of VZVr were observed in 37 patients (VZVr group). The proportion of prophylactic antiviral prescriptions and compliance with antiviral prophylaxis based on the NCCN Clinical Practice guidelines was 76% and 30% in the VZVr group, and 88% and 74% in the non-VZVr group, respectively. Multivariate analysis showed that compliance with the NCCN guidelines was the only independent risk factor for VZVr (p=0.0017).
CONCLUSION
It is important that prophylactic antivirals are prescribed for an appropriate duration of time to prevent the reactivation of VZV in compliance with existing guidelines.
背景/目的：在临床环境中，遵循美国国立综合癌症网络（NCCN）指南预防多发性骨髓瘤（MM）患者水痘带状疱疹病毒再激活（VZVr）的重要性尚未得到充分研究。
患者与方法
我们回顾性研究了118例接受蛋白酶体抑制剂治疗的MM患者的临床特征和结局。
结果
在37例患者中观察到39次VZVr发作（VZVr组）。VZVr组预防性抗病毒药物处方比例和基于NCCN临床实践指南的抗病毒预防依从性分别为76%和30%，非VZVr组分别为88%和74%。多变量分析显示，遵循NCCN指南是VZVr的唯一独立危险因素（p = 0.0017）。
结论
按照现有指南规定适当疗程使用预防性抗病毒药物以预防VZV再激活非常重要。
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