A Clinical Study on Varicella zoster Virus Infection, Relating Factors and Treatment in Pediatric Cancer Patients

ABSTRACT

PURPOSE: We performed this study to contribute to the prevention and treatment of Varicella zoster virus infection in pediatric cancer patients through understanding of VZV infection, acyclovir efficacy and varicella vaccination. METHODS: A retrospective study was performed by reviewing chart from January 1988 to January 2001. RESULTS: The diseases among 19 cases were leukemia. 12 cases were solid tumors. Fourteen of leukemic patients were in maintenance chemotherapy, two in off chemotherapy, one in remission state, and two in the intensification when infected by VZV. There were 25 males and 6 females. The average age was 5.1 +/- 1.9 years in the chicken pox(CP) group and 6.5 +/- 3.1 years in the herpes zoster(HZ) group. The mean time of acyclovir treatment was 9.0 +/- 2.4 days and 9.4 +/- 2.9 days, respectively. Acyclovir was very effective. However, 2 patients showed slight increase of ALT/ AST. The HZ group had a more varicella infection history than the CP group. In the CP group, four patients had a history of varicella vaccination. In the HZ group, one patient of two who were without an infection history had a vaccination history. CONCLUSIONS: The most common therapeutic phase when infected was maintenance therapy. The prevalence of CP was higher in a lower age group than the HZ group and the mean time of acyclovir treatment was 9.2 days. All patients were cured. Despite a higher infection history in the HZ group, because of the history of varicella vaccination, we concluded that varicella vaccination can not prevent VZV infection. However, further investigation is necessary for the effect of vaccination on the manifestation.