scholarly journals Postexposure Prophylaxis Against Varicella-Zoster Virus Infection Among Recipients of Hematopoietic Stem Cell Transplant: Unresolved Issues

2004 ◽  
Vol 25 (7) ◽  
pp. 603-608 ◽  
Author(s):  
David M. Weinstock ◽  
Michael Boeckh ◽  
Farid Boulad ◽  
Janet A. Eagan ◽  
Victoria J. Fraser ◽  
...  
Keyword(s):  
Stem Cell ◽  
Varicella Zoster Virus ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Varicella Zoster Virus Infection ◽  
Cell Transplant ◽  
Postexposure Prophylaxis ◽  
Hematopoietic Stem ◽  
Varicella Zoster

AbstractRecent guidelines for the prevention of opportunistic infections have addressed a variety of issues germane to recipients of hematopoietic stem cell transplant. However, there are several issues regarding postexposure prophylaxis against varicella-zoster virus that remain unresolved. We address these questions and offer several consensus recommendations.

scholarly journals Immunogenicity of Inactivated Varicella Zoster Vaccine in Autologous Hematopoietic Stem Cell Transplant Recipients and Patients With Solid or Hematologic Cancer

2020 ◽  
Vol 7 (7) ◽  
Author(s):  
Michael J Boeckh ◽  
Ann M Arvin ◽  
Kathleen M Mullane ◽  
Luis H Camacho ◽  
Drew J Winston ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Clinical Efficacy ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Geometric Mean ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Varicella Zoster

Abstract Background In phase 3 trials, inactivated varicella zoster virus (VZV) vaccine (ZVIN) was well tolerated and efficacious against herpes zoster (HZ) in autologous hematopoietic stem cell transplant (auto-HSCT) recipients and patients with solid tumor malignancies receiving chemotherapy (STMc) but did not reduce HZ incidence in patients with hematologic malignancies (HMs). Here, we describe ZVIN immunogenicity from these studies. Methods Patients were randomized to ZVIN or placebo (4 doses). Immunogenicity was assessed by glycoprotein enzyme-linked immunosorbent assay (gpELISA) and VZV interferon (IFN)-γ enzyme-linked immunospot (ELISPOT) assay in patients receiving all 4 doses without developing HZ at the time of blood sampling. Results Estimated geometric mean fold rise ratios (ZVIN/placebo) by gpELISA and IFN-y ELISPOT ~28 days post–dose 4 were 2.02 (95% confidence interval [CI], 1.53–2.67) and 5.41 (95% CI, 3.60–8.12) in auto-HSCT recipients; 1.88 (95% CI, 1.79–1.98) and 2.10 (95% CI, 1.69–2.62) in patients with STMc; and not assessed and 2.35 (95% CI, 1.81–3.05) in patients with HM. Conclusions ZVIN immunogenicity was directionally consistent with clinical efficacy in auto-HSCT recipients and patients with STMc even though HZ protection and VZV immunity were not statistically correlated. Despite a lack of clinical efficacy in patients with HM, ZVIN immunogenicity was observed in this population. Immunological results did not predict vaccine efficacy in these 3 populations. Clinical trial registration NCT01229267, NCT01254630.

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