Abstract
We report a retrospective analysis of children who underwent stem cell transplantations and subsequently developed a varicella-zoster virus (VZV) infection. Among 44 patients successfully transplanted between 1988 and 1994, 11 patients, aged 3 to 14 years, developed VZV infections (6 allogeneic BMT, 1 syngeneic BMT and 4 PBSCT); there were 9 herpes-zoster and 2 chicken-pox. In 6 cases, VZV infections occurred within 6 months after transplantation, and they appeared between 7 to 12 months in 4 patients. The ratio of CD4/CD8 decreased in lymphocytes from 3 out of 9 patients, and lymphocyte-response to PHA and Con. A depressed in 5 of 10 cases, but there was no significant relation between these laboratory data and the clinical courses.Acyclovir was administered with or without high-VZV-titer immunoglobulin to all the patients, and they were cured without any remarkable complication except postherpetic neuralgia which was observed in 2 older children.However, relapse of leukemia was recognized in 3 cases between 0.5 and 6 months after transplantation. Even though the mortality rate is low, VZV infection after stem cell transplantations should be carefully treated especially in patients with acute or chronic GVHD.
