Characteristics of HSV reaction episodes
| Age/ gender . | Diagnosis . | Pretransplantation HSV serology . | Posttransplantation day HSV documented . | CD4 count at HSV reactivation (no./mm3) . | Clinical course of HSV . | HSV sensitivity data . | CD4 count at HSV resolution (no./mm3) . | Survival (d) or cause of death . |
|---|---|---|---|---|---|---|---|---|
| 40/M | ALL-CR2 | +/− | +12 | 4 | Oral ulcers developed on IV ACV (prophylaxis), and stabilized on high-dose famciclovir. Lesions resolved ∼6 mo after transplantation, in association with immune reconstitution. | Day +97: ACV resistant Day +138: ACV resistant, foscarnet sensitive | 156 | Alive d +692 |
| 32/M | NHL (refractory) | +/+ | +57 | 8 | Buttocks ulcer developed while on no antivirals. Lesion stabilized on IV ACV and then famciclovir. Lesions resolved ∼6 mo after transplantation. | Day +131: ACV resistant, foscarnet sensitive | 24 | 306, relapse |
| 30/M | CML-CP2 | +/+ | +61 | 0 | Buttocks and esophageal ulcers developed on ganciclovir and stabilized on foscarnet. Lesions resolved ∼6 mo after transplantation in association with immune reconstitution. | Day +116: ACV resistant, foscarnet resistant (after 6 wk foscarnet therapy) | 242 | Alive day +538 |
| 39/F | AML-CR1 (poor risk) | +/+ | +22 | 0 | Buttocks and genital ulcers developed on IV ACV and progressed on foscarnet. Partial response to cidofovir. Lesions resolved ∼9 mo after transplantation, in association with immune reconstitution. Lesions recurred on day +378, in association with drop in CD4 to 22/mm3. HSV still active on high-dose famciclovir. | Day +47: ACV resistant, foscarnet sensitive Day +113: ACV resistant, foscarnet resistant (after 10 wk foscarnet therapy) | 208 | Alive day +448 |
| 21/M | ALL (refractory) | +/− | +48 | 44 | Esophageal ulcer developed on ganciclovir, and stabilized on foscarnet. Patient died with active ulcer (still culture +). | Day +69: ACV resistant, foscarnet resistant (after 3 wk foscarnet therapy) | NA | 73, aspergillosis |
| 47/M | AML (refractory) | +/+ | +40 | Not tested | Oral ulcers developed on ganciclovir. Patient died with active lesions 2 d after diagnosis of HSV. | Not tested | NA | 42, aspergillosis, multiorgan failure |
| 46/M | AML-CR1 (poor risk) | +/+ | +136 | 3 | Oral ulcers developed while on no antivirals. Patient treated with high-dose famciclovir. Died with active lesions 8 d after diagnosis of HSV. | Not tested | NA | 144, relapse |
| Age/ gender . | Diagnosis . | Pretransplantation HSV serology . | Posttransplantation day HSV documented . | CD4 count at HSV reactivation (no./mm3) . | Clinical course of HSV . | HSV sensitivity data . | CD4 count at HSV resolution (no./mm3) . | Survival (d) or cause of death . |
|---|---|---|---|---|---|---|---|---|
| 40/M | ALL-CR2 | +/− | +12 | 4 | Oral ulcers developed on IV ACV (prophylaxis), and stabilized on high-dose famciclovir. Lesions resolved ∼6 mo after transplantation, in association with immune reconstitution. | Day +97: ACV resistant Day +138: ACV resistant, foscarnet sensitive | 156 | Alive d +692 |
| 32/M | NHL (refractory) | +/+ | +57 | 8 | Buttocks ulcer developed while on no antivirals. Lesion stabilized on IV ACV and then famciclovir. Lesions resolved ∼6 mo after transplantation. | Day +131: ACV resistant, foscarnet sensitive | 24 | 306, relapse |
| 30/M | CML-CP2 | +/+ | +61 | 0 | Buttocks and esophageal ulcers developed on ganciclovir and stabilized on foscarnet. Lesions resolved ∼6 mo after transplantation in association with immune reconstitution. | Day +116: ACV resistant, foscarnet resistant (after 6 wk foscarnet therapy) | 242 | Alive day +538 |
| 39/F | AML-CR1 (poor risk) | +/+ | +22 | 0 | Buttocks and genital ulcers developed on IV ACV and progressed on foscarnet. Partial response to cidofovir. Lesions resolved ∼9 mo after transplantation, in association with immune reconstitution. Lesions recurred on day +378, in association with drop in CD4 to 22/mm3. HSV still active on high-dose famciclovir. | Day +47: ACV resistant, foscarnet sensitive Day +113: ACV resistant, foscarnet resistant (after 10 wk foscarnet therapy) | 208 | Alive day +448 |
| 21/M | ALL (refractory) | +/− | +48 | 44 | Esophageal ulcer developed on ganciclovir, and stabilized on foscarnet. Patient died with active ulcer (still culture +). | Day +69: ACV resistant, foscarnet resistant (after 3 wk foscarnet therapy) | NA | 73, aspergillosis |
| 47/M | AML (refractory) | +/+ | +40 | Not tested | Oral ulcers developed on ganciclovir. Patient died with active lesions 2 d after diagnosis of HSV. | Not tested | NA | 42, aspergillosis, multiorgan failure |
| 46/M | AML-CR1 (poor risk) | +/+ | +136 | 3 | Oral ulcers developed while on no antivirals. Patient treated with high-dose famciclovir. Died with active lesions 8 d after diagnosis of HSV. | Not tested | NA | 144, relapse |
ALL indicates acute lymphocytic leukemia; CR2, complete response; CP2, chronic phase 2; AML, acute myelogenous leukemia; IV, intravenous; for other abbreviations, see Table 1.