Assuntos
Regulação Neoplásica da Expressão Gênica/genética , Mutação , Fator 88 de Diferenciação Mieloide/genética , NF-kappa B/metabolismo , Transdução de Sinais , Macroglobulinemia de Waldenstrom/genética , Proteína bcl-X/biossíntese , Sequência de Aminoácidos , Sequência de Bases , Sobrevivência Celular , Análise Mutacional de DNA , Humanos , Immunoblotting , Imunoprecipitação , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Fator 88 de Diferenciação Mieloide/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Transdução de Sinais/fisiologia , Regulação para Cima , Macroglobulinemia de Waldenstrom/metabolismo , Proteína bcl-X/genéticaAssuntos
Cardiopatias/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Condicionamento Pré-Transplante/efeitos adversos , Condicionamento Pré-Transplante/métodos , Transplante Homólogo/efeitos adversos , Adolescente , Adulto , Idoso , Pressão Sanguínea , Cardiopatias/fisiopatologia , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: We retrospectively analyzed 80 instances of varicella zoster virus (VZV) disease in 72 patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) and examined the clinical differences between localized and disseminated disease. Risk factors for developing VZV dissemination were also evaluated. RESULTS: Of the 80 instances, 54 instances were localized diseases and 26 were disseminated diseases. Patient characteristics did not differ significantly between the 2 groups, except for the first-line therapy and the duration from symptom onset to treatment. In the disseminated group, intravenous acyclovir was used as the first-line therapy more frequently, and more time elapsed before beginning antiviral therapy compared with the localized group. In multivariate analyses, the duration from symptom onset to treatment was identified as an independent risk factor that significantly affected the development of VZV dissemination. Gender, total body irradiation, and chronic graft-versus-host disease, of which the latter 2 factors were reported as risk factors for the development of VZV disease after HSCT, did not affect the development of VZV dissemination. CONCLUSION: Our results suggest that VZV infection or reactivation may easily progress to viremia with delayed use of antiviral agents and may result in VZV dissemination in immunocompromised patients.
