PEDIATRICS Vol. 80 No. 4 October 1987, pp. 465-472
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Feldman, S.
Right arrow Articles by Loft, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Feldman, S.
Right arrow Articles by Loft, L.

Varicella in Children With Cancer: Impact of Antiviral Therapy and Prophylaxis

Sandor Feldman MD1 and Lennie Loft RN, PNP1

1 From the Division of Infectious Diseases, St Jude Children's Research Hospital, Memphis

To estimate the impact of antiviral therapy and prophylaxis on the natural course of the infection, 288 cases of varicella in children with cancer were reviewed. Among 127 patients with untreated infections, the overall mortality rate was 7%. Varicella-zoster virus pneumonitis developed in 28% of the untreated patients and was associated with a 25% mortality rate. Pneumonitis was much more likely to develop in patients with acute leukemia than in those with other malignancies (32% v 19%). Similarly, deaths due to pneumonitis were restricted to patients with acute leukemia. Lymphopenia (absolute lymphocyte count <500/µL) was significantly associated with varicella-zoster virus pneumonitis and a higher fatality rate among patients with this complication. Both acyclovir and adenine arabinoside, administered to 18 and 28 patients, respectively, stopped the progression of skin lesions; however, pneumonitis developed in none of the acyclovir recipients after two days of treatment, compared with 29% of the adenine arabinoside recipients (P = .03). Passive immunization in 45 children who subsequently had varicella was associated with an 11% incidence of varicella-zoster virus pneumonitis. Despite passive immunization of approximately 150 children, the attack rate of varicella at our institution remains unchanged. Results of this study demonstrate the efficacy of antiviral therapy and passive immunization in patients with childhood cancer and varicella, but prevention of the infection will require a universal vaccine.

Key Words: variceila • cancer

Submitted on July 10, 1986
Accepted on November 10, 1986




This article has been cited by other articles:


Home page
 J. Immunol.Home page
S.-K. Kim and R. M. Welsh
Comprehensive Early and Lasting Loss of Memory CD8 T Cells and Functional Memory during Acute and Persistent Viral Infections
J. Immunol., March 1, 2004; 172(5): 3139 - 3150.
[Abstract] [Full Text] [PDF]

Home page
 J. Immunol.Home page
C. D. Peacock, S.-K. Kim, and R. M. Welsh
Attrition of Virus-Specific Memory CD8+ T Cells During Reconstitution of Lymphopenic Environments
J. Immunol., July 15, 2003; 171(2): 655 - 663.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. A. Dodd, J. Burger, K. M. Edwards, and J. S. Dummer
Varicella in a Pediatric Heart Transplant Population on Nonsteroid Maintenance Immunosuppression
Pediatrics, November 1, 2001; 108(5): e80 - 80.
[Abstract] [Full Text] [PDF]

Home page
 J Antimicrob ChemotherHome page
Management of herpes virus infections following transplantation
J. Antimicrob. Chemother., June 1, 2000; 45(6): 729 - 748.
[Full Text] [PDF]