Predicting risk factors for varicella zoster virus infection and postherpetic neuralgia after hematopoietic cell transplantation using ordered logistic regression analysis

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• 作者：Yuko Kanbayashi ; Yosuke Matsumoto ; Junya Kuroda ; Tsutomu Kobayashi…
• 关键词：Key wordsVaricella zoster virus ; Postherpetic neuralgia ; Immunosuppressive therapy ; Hematopoietic cell transplantation
• 刊名：Annals of Hematology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：96
• 期：2
• 页码：311-315
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Hematology; Oncology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1432-0584
• 卷排序：96

文摘

To identify risk factors for varicella zoster virus (VZV) infection and postherpetic neuralgia (PHN) after hematopoietic cell transplantation (HCT), we conducted a retrospective chart review of 163 consecutive patients who underwent HCT between November 2004 and July 2014. Overall, the male/female (M/F) ratio was 80/83, median age at HCT was 54 (range 15–69) years, and autologous/allogeneic HCT (auto/allo-HCT) ratio was 71/92. Forty-four patients [M/F, 25/19; median age, 57 (range: 16–68) years; auto/allo-HCT, 26/18] developed VZV infection after HCT. All cases were successfully treated with acyclovir (ACV) or valacyclovir, and there was no VZV-related death. Nine (20%) of the 44 patients [M/F, 5/4; median age, 58 (range: 21–63) years; auto/allo-HCT, 7/2] developed PHN after resolution of zoster. Multivariate ordered logistic analysis identified receiving immunosuppressive therapy at the cessation of ACV [odds ratio (OR) = 74.53; 95% confidence interval (CI) = 6.99–794.32; P = 0.0004] as a risk factor for VZV infection and PHN in allo-HCT recipients. However, in auto-HCT recipients, only advanced age was identified as a risk factor (OR = 1.06, 95% CI = 1.002–1.127, P = 0.0429). Our findings indicate receiving immunosuppressive therapy at the cessation of ACV is a significant risk factor for allo-HCT recipients, while advanced age is a significant risk factor for auto-HCT recipients.