Herpesvirus hominis Infection in Patients with Myeloproliferative and Lymphoproliferative Disorders

Aston, D L; Cohen, A.; Spindler, Margaret A.

doi:10.1136/bmj.4.5838.462

Cited by 56 publications

(18 citation statements)

References 24 publications

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“…Aston et al (5) found HSV shedding in 3 of 54 (5.5%) patients with myeloproliferative and lymphoproliferative malignancy, which is similar to the incidence reported in normal populations (20). Within our patient population, the suppression of lymphocyte transformation to HSV antigen identified patients given both radiation and chemotherapy as being the group at highest risk of HSV reactivation during the first 12 mo of treatment.…”

Section: Cellular Itininunittx In Lyniphotna Patients Before Treatmentsupporting

confidence: 63%

“…Although cases of severe HSV infection in patients with lymphoma are well documented (5,7,19), and one patient in this study had fatal HSV encephalitis, this prospective study suggests that most patients with lymphoma either have no HSV reactivation or have uncomplicated infection. Aston et al (5) found HSV shedding in 3 of 54 (5.5%) patients with myeloproliferative and lymphoproliferative malignancy, which is similar to the incidence reported in normal populations (20).…”

Section: Cellular Itininunittx In Lyniphotna Patients Before Treatmentmentioning

confidence: 99%

“…Aston et al (5) found no differences in HSV-neutralizing antibody titers in patients with malignancy who had HSV lesions or asymptomatic shedding, and those with no evidence of reactivation. In a prospective study of renal transplant recipients, Luby et al (22) observed that VZ antibody titers were equivalent between patients who developed herpes zoster and those who did not.…”

Section: Cellular Itininunittx In Lyniphotna Patients Before Treatmentmentioning

confidence: 99%

“…The immunosuppressive therapy that is required to treat malignancy or to maintain transplanted organs is associated with the reactivation of latent herpes viral infections (1)(2)(3)(4)(5). The reactivation of varicella-zoster, herpes simplex, or cytomegalovirus can cause significant morbidity and mortality in immunocompromised patients despite the fact that the infection is recurrent rather than primary.…”

Section: Introductionmentioning

confidence: 99%

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Cellular and Humoral Immunity in the Pathogenesis of Recurrent Herpes Viral Infections in Patients with Lymphoma

Arvin¹,

Pollard²,

Rasmussen³

et al. 1980

J. Clin. Invest.

127

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A B S T R A C T 86 patients with lymphoma were evaluated prospectively for clinical and laboratory evidence ofrecurrent varicella-zoster, herpes simplex, and cytomegalovirus infections during the first 16 mo of treatment. Cellular immunity to the viral antigens was measured by in vitro lymphocyte transformation and interferon production. Antibody titers and nonspecific measures ofcellular immunity, including T-cell quantitation and transformation to phytohemagglutinin, were also assessed. The patients treated with radiation and chemotherapy had the highest incidence of reactivation of each of the viruses (15-19%). Greater susceptibility to herpes viral reactivation in these patients correlated with suppression of cell-mediated immunity to the specific virus. In individual patients, suppression of cellular immunity to the specific herpes viral antigen preceded each episode of reactivation, but recurrent infection did not occur in all patients with diminished specific lymphocyte transformation. Absence of the response appears to be a necessary but not a sufficient condition for the recrudescence of latent infection.Better preservation of cellular immnlunity to herpes simplex antigen during treatment was associated with infre(uent reactivation of herpes simplex. In 25 patients with acute herpes zoster, uncomplicated recovery from the infection was accompanied by the development of lymphocyte transformation and interferon production to varicella-zoster antigen. Quantitation of T-cell numbers and phytohemagglutinin transformation clid not correlate with the presence of viral cellular immunity in treated patients. Responses returned while T-cell numbers were low, and the The Abstract was presented at the Fourth Herpes Virus Meeting, Cold Spring Harbor, N. Y.

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Section: Cellular Itininunittx In Lyniphotna Patients Before Treatmentsupporting

confidence: 63%

Section: Cellular Itininunittx In Lyniphotna Patients Before Treatmentmentioning

confidence: 99%

Section: Cellular Itininunittx In Lyniphotna Patients Before Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cellular and Humoral Immunity in the Pathogenesis of Recurrent Herpes Viral Infections in Patients with Lymphoma

Arvin¹,

Pollard²,

Rasmussen³

et al. 1980

J. Clin. Invest.

127

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“…Herpetic infections are common in immunosuppressed patients with malignant diseases (Aston et al, 1972;Casazza et al, 1966;Lam et al, 1981;Meyers et al, 1980;Muller et al, 1972), and may be life threatening. The oral ulceration and stomatitis caused by HSV may be associated with significant morbidity.…”

mentioning

confidence: 99%

Oral acyclovir prophylaxis against herpes simplex virus in non-Hodgkin lymphoma and acute lymphoblastic leukaemia patients receiving remission induction chemotherapy. A randomised double blind, placebo controlled trial

Anderson¹,

Scarffe²,

Sutton³

et al. 1984

Br J Cancer

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Summary Forty-one patients receiving remission induction chemotherapy with vincristine, adriamycin and prednisolone (VAP) for high grade lymphoma or acute lymphoblastic leukaemia were entered into a double blind, placebo controlled trial of oral acyclovir prophylaxis against herpes simplex virus (HSV) infection. The dose of acyclovir was 200mg four times daily for the duration of chemotherapy (six weeks). Of the 40 evaluable patients, 20 were randomised to each arm. Prophylactic oral acyclovir significantly reduced the incidence of clinical HSV infection from 60% on placebo to 5% acyclovir (P<0.001), and the incidence of viral isolates from 70% on placebo to 5% on acyclovir (P<0.001).Herpetic infections are common in immunosuppressed patients with malignant diseases (Aston et al., 1972;Casazza et al., 1966;Lam et al., 1981;Meyers et al., 1980;Muller et al., 1972), and may be life threatening. The oral ulceration and stomatitis caused by HSV may be associated with significant morbidity. In the past year eight of 25 (32%) patients with non-Hodgkin's lymphoma, admitted to our oncology ward with pyrexia when neutropenic, had virologically confirmed HSV infections. Intravenous acyclovir has been shown in randomised, placebo controlled trials to be effective in the treatment of HSV infection in immunocompromised patients (Chou et al., 1981;Mitchell et al., 1981;Wade et al., 1982), and in the prophylaxis of HSV infection (Hann et al., 1983;Saral et al. 1981). A report of oral acyclovir prophylaxis in bone marrow transplant patients has shown a reduced incidence of HSV in those patients treated with acyclovir compared with placebo, without significant toxicity (Gluckman et al. 1983). The aim of this trial was to evaluate the efficacy of prophylactic oral acyclovir against HSV infections in lymphoma and leukaemia patients receiving remission induction chemotherapy, in a double blind placebo controlled trial. Patients and methodsForty-one patients with high grade non-Hodgkin lymphoma or acute lymphoblastic leukaemia who were to receive chemotherapy using the VAP regimen (Blackledge et al., 1980) (Vincristine 2mg intravenously weekly for six weeks, Adriamycin 60 mgm-2 intravenously fortnightly for three doses, and oral prednisolone at 50 mg day-1 for six weeks)were eligible for the trial. After obtaining informed consent patients were randomised to receive acyclovir 200mg four times daily or placebo tablets of identical appearance. The tablets commenced on the first day of chemotherapy and were prescribed for six weeks.Patients with non-Hodgkin lymphoma attended the outpatient clinic for examination and treatment each week, and those with acute leukaemia were inpatients for the duration of therapy. Throat swabs and blood samples for haematology, biochemistry and acyclovir levels were taken weekly. Blood for viral serology was taken every three weeks. At each outpatient visit patients were asked about oral symptoms and coldsores. Lesions present at the time of consultation were swabbed for viral culture and if applicable sa...

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Herpetic Meningitis (Type 1) in a Case of Acute Leukemia

Cappel¹,

Klastersky²

1973

Archives of Neurology

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Herpesvirus hominis Infection in Patients with Myeloproliferative and Lymphoproliferative Disorders

Cited by 56 publications

References 24 publications

Cellular and Humoral Immunity in the Pathogenesis of Recurrent Herpes Viral Infections in Patients with Lymphoma

Cellular and Humoral Immunity in the Pathogenesis of Recurrent Herpes Viral Infections in Patients with Lymphoma

Oral acyclovir prophylaxis against herpes simplex virus in non-Hodgkin lymphoma and acute lymphoblastic leukaemia patients receiving remission induction chemotherapy. A randomised double blind, placebo controlled trial

Herpetic Meningitis (Type 1) in a Case of Acute Leukemia

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