Variable Clinical Courses of Varicella Zoster Virus Infection-related or Vaccination-related Bone Marrow Failure.

Pub Date : 2024-04-23 DOI:10.1097/MPH.0000000000002866
Vasil Toskov, Annámaria Cseh, A. Claviez, Beatrice Drexler, Natalia Rotari, S. Schwarz-Furlan, Matthias Braun, Peter Bader, Peter Lang, Rita Beier, Bernhard Erdlenbruch, Monika Führer, M. Erlacher, Charlotte M. Niemeyer, B. Strahm, A. Yoshimi
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Abstract

We report 5 children with bone marrow failure (BMF) after primary varicella zoster virus (VZV) infection or VZV vaccination, highlighting the highly variable course. Two patients were treated with intravenous immunoglobulins; one had a slow hematologic recovery, and the other was rescued by allogeneic hematopoietic stem cell transplantation (HSCT). Of the 2 patients treated with immunosuppressive therapy with antithymocyte globulin and cyclosporine, one had a complete response, and the other was transplanted for nonresponse. One patient underwent a primary allograft. All patients are alive. This study demonstrated that VZV-associated BMF is a life-threatening disorder that often requires HSCT.
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水痘带状疱疹病毒感染相关或疫苗接种相关骨髓衰竭的临床过程各不相同。
我们报告了5名原发性水痘带状疱疹病毒(VZV)感染或接种VZV疫苗后出现骨髓衰竭(BMF)的儿童,突出强调了病程的高度可变性。其中两名患者接受了静脉注射免疫球蛋白治疗,一名患者的血液学恢复缓慢,另一名患者则通过异基因造血干细胞移植(HSCT)得到了救治。在接受抗胸腺细胞球蛋白和环孢素免疫抑制治疗的两名患者中,一人获得完全应答,另一人因无应答而进行了移植。一名患者接受了初次异体移植。所有患者均存活。这项研究表明,VZV 相关性骨髓纤维化是一种危及生命的疾病,通常需要进行造血干细胞移植。
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