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A Japanese single‐hospital observational trial with a retrospective case‐control analysis of varicella zoster virus reactivation after autologous peripheral blood stem cell transplantation
Author(s) -
Mawatari M.,
Isoda A.,
Miyazawa Y.,
Sawamura M.,
Matsumoto M.
Publication year - 2015
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12406
Subject(s) - medicine , cumulative incidence , varicella zoster virus , incidence (geometry) , retrospective cohort study , univariate analysis , transplantation , hematopoietic stem cell transplantation , multivariate analysis , surgery , immunology , virus , physics , optics
Background Varicella zoster virus ( VZV ) reactivation following hematopoietic stem cell transplantation ( SCT ) is common. To help reduce its incidence and to identify predictive factors for VZV reactivation after autologous SCT (auto‐ SCT ), we conducted a retrospective analysis in patients with hematologic malignancy at our hospital. Methods We conducted a single‐hospital observational trial with a retrospective case‐control analysis of post‐auto‐ SCT VZV reactivation in patients with malignant lymphoma ( ML ) and multiple myeloma ( MM ) between January 2001 and December 2010, in the Department of Hematology at our hospital. First, we analyzed the cumulative incidence of VZV reactivation during the post‐ SCT period. Second, we conducted a case‐control analysis to identify the risk factors for VZV reactivation within 1 year after SCT . Univariate analyses were performed using Fisher's exact test for categorical variables. A multivariable model and logistic regression were used to assess the risk factors for VZV reactivation. Results We included 97 patients in this study. The median duration of follow‐up was 1027 days. Forty‐two patients experienced VZV reactivation after SCT , while 29 (69.0%) experienced reactivation within 1 year after SCT . The cumulative incidence was 30.7% at 1 year and 51.2% for the total observation period. Multivariate analysis showed that engraftment after day 10 was an independent risk factor for VZV reactivation ( P = 0.03). Conclusions Our study showed a high incidence of VZV reactivation in the first year after auto‐ SCT in ML and MM patients. Patients with delayed engraftment are at high risk for VZV reactivation and should be considered for prolonged VZV prophylaxis.