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Varicella-zoster virus-specific cell-mediated immunity and herpes zoster development in multiple myeloma patients receiving bortezomib- or thalidomide-based chemotherapy

Title
Varicella-zoster virus-specific cell-mediated immunity and herpes zoster development in multiple myeloma patients receiving bortezomib- or thalidomide-based chemotherapy
Authors
Kim, Ji-WonMin, Chang-KiMun, Yeung-ChulPark, YongKim, Byung SooNam, Seung-HyunKoh, YoungilKwon, Ji-HyunChoe, Pyoeng GyunPark, Wan BeomKim, Inho
Ewha Authors
문영철
SCOPUS Author ID
문영철scopus
Issue Date
2015
Journal Title
JOURNAL OF CLINICAL VIROLOGY
ISSN
1386-6532JCR Link1873-5967JCR Link
Citation
vol. 73, pp. 64 - 69
Keywords
Varicella-zoster virusEnzyme-linked immunospot assayHerpes zosterMultiple myelomaBortezomib
Publisher
ELSEVIER SCIENCE BV
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Background: The incidence of herpes zoster is substantial during bortezomib treatment in patients with multiple myeloma (MM). Objectives: This study aimed to elucidate the effect of chemotherapy with or without bortezomib in MM patients on their herpes zoster incidence and varicella zoster virus (VZV)-specific cell-mediated immunity (CMI). Study design: Peripheral blood mononuclear cells were collected at baseline and after 1 month of bortezomib-based or thalidomide-based chemotherapy and then analyzed using VZV-specific interferongamma (IFN-gamma) enzyme-linked immunospot (ELISPOT) assay. The clinical data from these patients were analyzed in relation to the ELISPOT results. Results: Of 58 patients analyzed, 39 patients received bortezomib and the other 19 patients, thalidomide. Among them, 5 patients developed herpes zoster during chemotherapy; all 5 were being treated with the bortezomib-based regimen and were not receiving prophylactic anti-viral agents. The median onset of herpes zoster was 32 days (range, 15-95 days) from the initiation of chemotherapy. Among patients who received bortezomib therapy, acyclovir prophylaxis significantly reduced the risk for herpes zoster (100-day cumulative incidence, 0% vs. 49.5%; p < 0.001). Spot-forming cell (SFC) counts in the IFN-gamma ELISPOT assay decreased from baseline after bortezomib (p = 0.011) or thalidomide (p = 0.096) treatment. Patients with baseline SFCs greater than 20/10(6) mononuclear cells exhibited significantly higher incidence of herpes zoster (100-day cumulative incidence, 34.8% vs. 0%; p = 0.040). Conclusions: Bortezomib treatment significantly reduced VZV-specific CMI, and high baseline SFC counts in patients receiving this treatment without acyclovir prophylaxis were associated with a significantly increased risk for herpes zoster. (C) 2015 Elsevier B.V. All rights reserved.
DOI
10.1016/j.jcv.2015.10.018
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의학전문대학원 > 의학과 > Journal papers
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