Article Type
News
Changed
Fri, 01/04/2019 - 11:06
Display Headline
Acyclovir Prophylaxis Against Varicella Zoster Virus Reactivation in Multiple Myeloma Patients Treated With Bortezomib-Based Therapies: A Retrospective Analysis of 100 Patients

Original research

Acyclovir Prophylaxis Against Varicella Zoster Virus Reactivation in Multiple Myeloma Patients Treated With Bortezomib-Based Therapies: A Retrospective Analysis of 100 Patients

  • Abhisek Swaika, MD; Aneel Paulus, MD/ Kena C. Miller; MSN, FNP; Tamur Sher, MD; Nikolaos G. Almyroudis, MD; Donna Ball, NP; Margaret Wood; MSN; Aisha Masood, MD; Kelvin Lee, MD; Asher A. Chanan-Khan, MD

    Abstract

    Background

    Previous studies have indicated that, in patients with multiple myeloma (MM), bortezomib is associated with an increased incidence of herpes zoster, resulting from reactivation of latent varicella zoster virus (VZV).

    Objective

    Our objective was to determine whether increased risk of VZV reactivation could be abrogated by using prophylactic acyclovir.

    Methods

    We retrospectively evaluated 100 consecutive MM patients treated with bortezomib-based therapies at the Roswell Park Cancer Institute for development of herpes zoster. Frontline and relapsed/refractory patients were included, and patients received bortezomib alone or in combination with agents such as doxorubicin, melphalan, or dexamethasone. All patients received >4 weeks of acyclovir prophylaxis (400 mg twice daily), which was initiated prior to starting treatment with bortezomib and discontinued 4 weeks following bortezomib.

    Results

    Median patient age was 62 years, 57% were male, and most (56%) had Durie-Salmon stage IIIA MM. None of the 100 MM patients receiving acyclovir prophylaxis developed herpes zoster during treatment with bortezomib, irrespective of patients receiving a wide variety of concomitant antimyeloma therapies and regardless of response to bortezomib-based therapy. One additional patient, found to be noncompliant with acyclovir therapy, experienced VZV reactivation, having received 3 cycles of bortezomib (3 weeks each cycle) in combination with cyclophosphamide and dexamethasone.

    Limitations

    Limitations of the study include its small size and retrospective nature.

    Conclusions

    The increased risk of VZV reactivation observed in previous studies of bortezomib-based therapy was completely abrogated in this series of patients who received prophylaxis with acyclovir.

    *For a PDF of the full article click in the link to the left of this introduction.

Article PDF
Article PDF
Author and Disclosure Information

Publications
The Journal of Community and Supportive Oncology
MDedge Hematology and Oncology
Topics
Lymphoma & Plasma Cell Disorders
Sections
Research
Original Report
Author and Disclosure Information

Author and Disclosure Information

Article PDF
Article PDF
Article PDF
Article PDF

Original research

Acyclovir Prophylaxis Against Varicella Zoster Virus Reactivation in Multiple Myeloma Patients Treated With Bortezomib-Based Therapies: A Retrospective Analysis of 100 Patients

  • Abhisek Swaika, MD; Aneel Paulus, MD/ Kena C. Miller; MSN, FNP; Tamur Sher, MD; Nikolaos G. Almyroudis, MD; Donna Ball, NP; Margaret Wood; MSN; Aisha Masood, MD; Kelvin Lee, MD; Asher A. Chanan-Khan, MD

    Abstract

    Background

    Previous studies have indicated that, in patients with multiple myeloma (MM), bortezomib is associated with an increased incidence of herpes zoster, resulting from reactivation of latent varicella zoster virus (VZV).

    Objective

    Our objective was to determine whether increased risk of VZV reactivation could be abrogated by using prophylactic acyclovir.

    Methods

    We retrospectively evaluated 100 consecutive MM patients treated with bortezomib-based therapies at the Roswell Park Cancer Institute for development of herpes zoster. Frontline and relapsed/refractory patients were included, and patients received bortezomib alone or in combination with agents such as doxorubicin, melphalan, or dexamethasone. All patients received >4 weeks of acyclovir prophylaxis (400 mg twice daily), which was initiated prior to starting treatment with bortezomib and discontinued 4 weeks following bortezomib.

    Results

    Median patient age was 62 years, 57% were male, and most (56%) had Durie-Salmon stage IIIA MM. None of the 100 MM patients receiving acyclovir prophylaxis developed herpes zoster during treatment with bortezomib, irrespective of patients receiving a wide variety of concomitant antimyeloma therapies and regardless of response to bortezomib-based therapy. One additional patient, found to be noncompliant with acyclovir therapy, experienced VZV reactivation, having received 3 cycles of bortezomib (3 weeks each cycle) in combination with cyclophosphamide and dexamethasone.

    Limitations

    Limitations of the study include its small size and retrospective nature.

    Conclusions

    The increased risk of VZV reactivation observed in previous studies of bortezomib-based therapy was completely abrogated in this series of patients who received prophylaxis with acyclovir.

    *For a PDF of the full article click in the link to the left of this introduction.

Original research

Acyclovir Prophylaxis Against Varicella Zoster Virus Reactivation in Multiple Myeloma Patients Treated With Bortezomib-Based Therapies: A Retrospective Analysis of 100 Patients

  • Abhisek Swaika, MD; Aneel Paulus, MD/ Kena C. Miller; MSN, FNP; Tamur Sher, MD; Nikolaos G. Almyroudis, MD; Donna Ball, NP; Margaret Wood; MSN; Aisha Masood, MD; Kelvin Lee, MD; Asher A. Chanan-Khan, MD

    Abstract

    Background

    Previous studies have indicated that, in patients with multiple myeloma (MM), bortezomib is associated with an increased incidence of herpes zoster, resulting from reactivation of latent varicella zoster virus (VZV).

    Objective

    Our objective was to determine whether increased risk of VZV reactivation could be abrogated by using prophylactic acyclovir.

    Methods

    We retrospectively evaluated 100 consecutive MM patients treated with bortezomib-based therapies at the Roswell Park Cancer Institute for development of herpes zoster. Frontline and relapsed/refractory patients were included, and patients received bortezomib alone or in combination with agents such as doxorubicin, melphalan, or dexamethasone. All patients received >4 weeks of acyclovir prophylaxis (400 mg twice daily), which was initiated prior to starting treatment with bortezomib and discontinued 4 weeks following bortezomib.

    Results

    Median patient age was 62 years, 57% were male, and most (56%) had Durie-Salmon stage IIIA MM. None of the 100 MM patients receiving acyclovir prophylaxis developed herpes zoster during treatment with bortezomib, irrespective of patients receiving a wide variety of concomitant antimyeloma therapies and regardless of response to bortezomib-based therapy. One additional patient, found to be noncompliant with acyclovir therapy, experienced VZV reactivation, having received 3 cycles of bortezomib (3 weeks each cycle) in combination with cyclophosphamide and dexamethasone.

    Limitations

    Limitations of the study include its small size and retrospective nature.

    Conclusions

    The increased risk of VZV reactivation observed in previous studies of bortezomib-based therapy was completely abrogated in this series of patients who received prophylaxis with acyclovir.

    *For a PDF of the full article click in the link to the left of this introduction.

Publications
The Journal of Community and Supportive Oncology
MDedge Hematology and Oncology
Publications
The Journal of Community and Supportive Oncology
MDedge Hematology and Oncology
Topics
Lymphoma & Plasma Cell Disorders
Article Type
News
Display Headline
Acyclovir Prophylaxis Against Varicella Zoster Virus Reactivation in Multiple Myeloma Patients Treated With Bortezomib-Based Therapies: A Retrospective Analysis of 100 Patients
Display Headline
Acyclovir Prophylaxis Against Varicella Zoster Virus Reactivation in Multiple Myeloma Patients Treated With Bortezomib-Based Therapies: A Retrospective Analysis of 100 Patients
Sections
Research
Original Report
Article Source

PURLs Copyright

Inside the Article

Article PDF Media