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HHV‐6 encephalitis in pediatric unrelated umbilical cord transplantation: A role for ganciclovir prophylaxis?
Author(s) -
Cheng Frankie Wai Tsoi,
Lee Vincent,
Leung Wing Kwan,
Chan Paul Kay Sheung,
Leung Ting Fan,
Shing Ming Kong,
Li Chi Kong
Publication year - 2010
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2009.01253.x
Subject(s) - medicine , ganciclovir , encephalitis , pediatrics , complication , transplantation , retrospective cohort study , umbilical cord , surgery , human cytomegalovirus , immunology , virus
Cheng FWT, Lee V, Leung WK, Chan PKS, Leung TF, Shing MK, Li CK. HHV‐6 encephalitis in pediatric unrelated umbilical cord transplantation: A role for ganciclovir prophylaxis?
Pediatr Transplantation 2010: 14:483–487. © 2009 John Wiley & Sons A/S. Abstract: The role of ganciclovir as HHV‐6 prophylaxis in unrelated HSCT setting remains controversial. We performed an eight‐yr retrospective review of patients received unrelated HSCT from January 2000 to September 2008. From January 2002, ganciclovir prophylaxis 5 mg/kg twice daily for seven days for all unrelated HSCT before transplant was adopted. The prevalence of HHV‐6 encephalitis was studied before and after the change in policy. Fifty‐four unrelated HSCT were performed from January 2000 to September 2008. Four cases (7.4%) of HHV‐6 encephalitis were diagnosed. All of them were due to variant B infection. Two cases out of 16 cases (12.5%) were diagnosed before adoption of the policy; two cases out of 38 cases (5.3%) were diagnosed afterward. All of them were unrelated UCB transplant recipients. They were all seropositive to HHV‐6 before transplant. Two cases complicated with significant residual neurological deficit and refractory seizure. The other two cases died of other transplant‐related mortalities. We conclude that HHV‐6 encephalitis is still a rare complication of unrelated HSCT and may be more common in unrelated UCB transplant. Routine use of ganciclovir as HHV‐6 prophylaxis in all unrelated HSCT recipients may not be justified but may have a role in unrelated UCB transplant.