Department of Dermatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
Chongqing Medical University, Chongqing, China.
Arch Dermatol Res. 2024 Jun 1;316(6):314. doi: 10.1007/s00403-024-03043-8.
Herpes zoster (HZ) is rare in healthy children, but more prevalent in those with leukemia. Optimal timing of chemotherapy reinitiation after HZ treatment is challenging because chemotherapy suppresses immunity and increases risk of HZ relapse. We aimed to optimize the timing of chemotherapy reinitiation after HZ therapy in children with leukemia. The study included 31 children with acute leukemia and HZ infection. General information, clinical symptoms, laboratory test results, duration of HZ treatment, and prognosis were compared with those of children with leukemia alone. Correlation analysis was performed for 20 children who restarted chemotherapy after HZ treatment. Of 31 children with leukemia and HZ, 67.74% had lesions at multiple sites. The median time from chemotherapy initiation to HZ onset was 14.1 (1.5-29.5) months. Among 27 children included in the follow-up, there was one case of HZ relapse. After excluding children who did not continue chemotherapy after HZ treatment, the median interval between completion of HZ therapy and chemotherapy reinitiation in the remaining 20 children was 8.00 (- 3 to 27) days. Lymphocyte counts (LY#) on restarting chemotherapy correlated inversely with HZ lesion healing time (p < 0.05). LY# at the time of HZ onset were lower than those pre- and post-onset, and lower than those in the control group (p < 0.05). In conclusion, children with leukemia have a good HZ prognosis, but an increased risk of HZ recurrence. LY# at the time of chemotherapy reinitiation may be a useful indicator for selecting the optimal interval between antiviral therapy completion and chemotherapy reinitiation.
带状疱疹（HZ）在健康儿童中很少见，但在白血病儿童中更为常见。HZ 治疗后化疗重新开始的最佳时机具有挑战性，因为化疗会抑制免疫力并增加 HZ 复发的风险。我们旨在优化白血病儿童 HZ 治疗后化疗重新开始的时机。该研究纳入了 31 例急性白血病合并 HZ 感染的患儿。比较了他们的一般资料、临床症状、实验室检查结果、HZ 治疗持续时间和预后，并与单纯白血病患儿进行了比较。对 20 例 HZ 治疗后重新开始化疗的患儿进行了相关性分析。在 31 例白血病合并 HZ 的患儿中，67.74%的患儿有多处病变。从化疗开始到 HZ 发病的中位时间为 14.1（1.5-29.5）个月。在 27 例纳入随访的患儿中，有 1 例 HZ 复发。排除 HZ 治疗后未继续化疗的患儿后，其余 20 例患儿 HZ 治疗完成至化疗重新开始的中位时间间隔为 8.00（-3 至 27）天。重新开始化疗时的淋巴细胞计数（LY#）与 HZ 皮损愈合时间呈负相关（p<0.05）。HZ 发病时的 LY#低于发病前和发病后的 LY#，且低于对照组（p<0.05）。总之，白血病患儿 HZ 预后良好，但 HZ 复发风险增加。化疗重新开始时的 LY#可能是选择抗病毒治疗完成与化疗重新开始之间最佳间隔的有用指标。
