BACKGROUND: Currently, acyclovir (ACV) at 1000 mg/day is widely used as prophylaxis in the early phase of hematopoietic stem cell transplant (HSCT) in Japan. However, low-dose ACV (200 mg/day) has been shown to prevent varicella zoster virus reactivation in the middle and late phases of HSCT. METHODS: Therefore, in this study, we decreased the dose of ACV to 200 mg/day in the early phase after HSCT. We analyzed 93 consecutive herpes simplex virus (HSV)-seropositive patients who underwent allogeneic HSCT for the first time in our center between June 2007 and December 2011. RESULTS: Before August 2009, 38 patients received oral ACV at 1000 mg/day (ACV1000) until day 35 after HSCT, whereas 55 patients received oral ACV at 200 mg/day (ACV200) after September 2009. We compared the cumulative incidence of HSV infection in the 2 groups. Oral ACV was changed to intravenous administration because of intolerance in 66% and 45% of the patients in the ACV1000 and ACV200 groups, respectively (P = 0.060). The probability of severe stomatitis (Bearman grade II-III) was 76% and 60% in the ACV1000 and ACV200 groups, respectively (P = 0.12). The number of patients who developed HSV disease before day 100 after HSCT was 0 in the ACV1000 group and 2 in the ACV200 group, with a cumulative incidence of 3.6% (P = 0.43). HSV disease in the latter 2 patients was limited to the lips and tongue and was successfully treated with ACV or valacyclovir at a treatment dose. CONCLUSION: ACV at 200 mg/day appeared to be effective for preventing HSV disease in the early phase after HSCT.
BACKGROUND: Currently, acyclovir (ACV) at 1000 mg/day is widely used as prophylaxis in the early phase of hematopoietic stem cell transplant (HSCT) in Japan. However, low-dose ACV (200 mg/day) has been shown to prevent varicella zoster virus reactivation in the middle and late phases of HSCT. METHODS: Therefore, in this study, we decreased the dose of ACV to 200 mg/day in the early phase after HSCT. We analyzed 93 consecutive herpes simplex virus (HSV)-seropositive patients who underwent allogeneic HSCT for the first time in our center between June 2007 and December 2011. RESULTS: Before August 2009, 38 patients received oral ACV at 1000 mg/day (ACV1000) until day 35 after HSCT, whereas 55 patients received oral ACV at 200 mg/day (ACV200) after September 2009. We compared the cumulative incidence of HSV infection in the 2 groups. Oral ACV was changed to intravenous administration because of intolerance in 66% and 45% of the patients in the ACV1000 and ACV200 groups, respectively (P = 0.060). The probability of severe stomatitis (Bearman grade II-III) was 76% and 60% in the ACV1000 and ACV200 groups, respectively (P = 0.12). The number of patients who developed HSV disease before day 100 after HSCT was 0 in the ACV1000 group and 2 in the ACV200 group, with a cumulative incidence of 3.6% (P = 0.43). HSV disease in the latter 2 patients was limited to the lips and tongue and was successfully treated with ACV or valacyclovir at a treatment dose. CONCLUSION:ACV at 200 mg/day appeared to be effective for preventing HSV disease in the early phase after HSCT.
Authors: Y Kanda; T Kobayashi; T Mori; M Tanaka; C Nakaseko; A Yokota; R Watanabe; S Kako; K Kakihana; J Kato; A Tanihara; N Doki; M Ashizawa; S-I Kimura; M Kikuchi; H Kanamori; S Okamoto Journal: Bone Marrow Transplant Date: 2015-10-05 Impact factor: 5.483
Authors: Sharon Elad; Vinisha Ranna; Anura Ariyawardana; Maria Elvira Pizzigatti Correa; Vanessa Tilly; Raj G Nair; Tanya Rouleau; Richard M Logan; Andres Pinto; Veronica Charette; Debbie P Saunders; Siri Beier Jensen Journal: Support Care Cancer Date: 2016-11-16 Impact factor: 3.603
Authors: Ella J Ariza-Heredia; Roy F Chemaly; Lokesh R Shahani; Ying Jang; Richard E Champlin; Victor E Mulanovich Journal: Transpl Int Date: 2018-03-13 Impact factor: 3.782
Authors: Ndeye Soukeyna Diop; Pascal Roland Enok Bonong; Chantal Buteau; Michel Duval; Jacques Lacroix; Louise Laporte; Marisa Tucci; Nancy Robitaille; Philip C Spinella; Geoffrey Cuvelier; Suzanne M Vercauteren; Victor Lewis; Caroline Alfieri; Helen Trottier Journal: Vaccines (Basel) Date: 2021-06-07