Lymphocyte counts predict optimal timing of chemotherapy reinitiation after antivirus treatment for herpes zoster in children with leukemia

作者全名：Zhang, Xuanlu; Feng, Ye; Luo, Xiaoyan; Wang, Hua; Tan, Qi; Dou, Ying; Zhao, Yao; Bai, Xiaoming

作者地址：[Zhang, Xuanlu; Luo, Xiaoyan; Wang, Hua; Tan, Qi; Bai, Xiaoming] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Key Lab Child Dev & Disorders, Dept Neurosurg,Childrens Hosp,Minist Educ,Dept Der, Chongqing, Peoples R China; [Zhang, Xuanlu] Chongqing Med Univ, Chongqing, Peoples R China; [Feng, Ye; Dou, Ying] Chongqing Med Univ, Dept Hematol, Childrens Hosp, Chongqing, Peoples R China; [Zhao, Yao; Bai, Xiaoming] Chongqing Key Lab Child Rare Dis Infect & Immun, Chongqing, Peoples R China; [Bai, Xiaoming] Chongqing Med Univ, Jiangxi Childrens Med Ctr, Childrens Hosp, Jiangxi Hosp, Chongqing, Jiangxi, Peoples R China

通信作者：Bai, XM (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Key Lab Child Dev & Disorders, Dept Neurosurg,Childrens Hosp,Minist Educ,Dept Der, Chongqing, Peoples R China.; Bai, XM (通讯作者)，Chongqing Key Lab Child Rare Dis Infect & Immun, Chongqing, Peoples R China.; Bai, XM (通讯作者)，Chongqing Med Univ, Jiangxi Childrens Med Ctr, Childrens Hosp, Jiangxi Hosp, Chongqing, Jiangxi, Peoples R China.

来源：ARCHIVES OF DERMATOLOGICAL RESEARCH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001237876500012

JCR分区：Q3

影响因子：1.8

年份：2024

卷号：316

期号：6

开始页：　

结束页：　

文献类型：Review

关键词：Herpes zoster; Leukemia; Chemotherapy; Lymphocyte; Relapse

摘要：Herpes zoster (HZ) is rare in healthy children, but more prevalent in those with leukemia. Optimal timing of chemotherapy reinitiation after HZ treatment is challenging because chemotherapy suppresses immunity and increases risk of HZ relapse. We aimed to optimize the timing of chemotherapy reinitiation after HZ therapy in children with leukemia. The study included 31 children with acute leukemia and HZ infection. General information, clinical symptoms, laboratory test results, duration of HZ treatment, and prognosis were compared with those of children with leukemia alone. Correlation analysis was performed for 20 children who restarted chemotherapy after HZ treatment. Of 31 children with leukemia and HZ, 67.74% had lesions at multiple sites. The median time from chemotherapy initiation to HZ onset was 14.1 (1.5-29.5) months. Among 27 children included in the follow-up, there was one case of HZ relapse. After excluding children who did not continue chemotherapy after HZ treatment, the median interval between completion of HZ therapy and chemotherapy reinitiation in the remaining 20 children was 8.00 (- 3 to 27) days. Lymphocyte counts (LY#) on restarting chemotherapy correlated inversely with HZ lesion healing time (p < 0.05). LY# at the time of HZ onset were lower than those pre- and post-onset, and lower than those in the control group (p < 0.05). In conclusion, children with leukemia have a good HZ prognosis, but an increased risk of HZ recurrence. LY# at the time of chemotherapy reinitiation may be a useful indicator for selecting the optimal interval between antiviral therapy completion and chemotherapy reinitiation.

基金机构：National Natural Science Foundation of China

基金资助正文：We are grateful to the children and their families who participated in the study.