Topical treatment of acyclovir-resistant herpes simplex virus stomatitis after allogeneic hematopoietic cell transplantation

• Verfasst von: Heidenreich, Daniela [VerfasserIn]
• Verfasst von: Kreil, Sebastian [VerfasserIn]
• Verfasst von: Müller, Nadine Zoé [VerfasserIn]
• Verfasst von: Jawhar, Mohamad [VerfasserIn]
• Verfasst von: Nolte, Florian [VerfasserIn]
• Verfasst von: Hofmann, Wolf-Karsten [VerfasserIn]
• Verfasst von: Klein, Stefan [VerfasserIn]
• Titel: Topical treatment of acyclovir-resistant herpes simplex virus stomatitis after allogeneic hematopoietic cell transplantation
• Verf.angabe: Daniela Heidenreich, Sebastian Kreil, Nadine Mueller, Mohamad Jawhar, Florian Nolte, Wolf-Karsten Hofmann, Stefan A. Klein
• E-Jahr: 2020
• Jahr: October 16, 2020
• Umfang: 6 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 01.10.2024
• Titel Quelle: Enthalten in: Oncology research and treatment
• Ort Quelle: Basel : Karger, 2014
• Jahr Quelle: 2020
• Band/Heft Quelle: 43(2020), 12 vom: Dez., Seite 672-677
• ISSN Quelle: 2296-5262
• DOI: doi:10.1159/000510988
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1903850193

Abstract

Introduction: We report on patients who developed severe acyclovir-resistant (ACVr) herpes simplex virus 1 (HSV-1) stomatitis after allogeneic hematopoietic cell transplantation (HCT). Patients: HCT patients suffering from HSV-1 stomatitis without response after 1 week of high-dose acyclovir (ACV) were tested for ACV resistance. Patients with proven ACV resistance were treated either topically with cidofovir solution and gel or with topical foscavir cream or with intravenous foscavir. Results: Among 214 consecutive HCT patients, 6 developed severe ACVr HSV-1 stomatitis (WHO grade III n = 1, WHO grade IV n = 5). All 6 patients suffered from relapse of acute myeloid leukemia (AML) after HCT. ACVr stomatitis was treated topically with first-line (n = 4) or second-line (n = 2) cidofovir. Topical foscavir cream was applied as first-line (n = 1) or second-line (n = 1) therapy. Intravenous foscavir was used in 3 patients (first-line therapy, n = 1; second-line therapy, n = 2). Complete remission was reached by topical cidofovir (n = 3), topical foscavir (n = 1), and intravenous foscavir (n = 1), respectively. Five of the 6 patients died due to progression of leukemia. Only 1 patient survived. Conclusions: ACVr HSV-1 stomatitis is a severe complication in AML patients relapsing after HCT. It reflects the seriously impaired general condition of these patients. This analysis shows that topical treatment with cidofovir or foscavir might be a sufficient first-line therapy approach in ACVr HSV-1 stomatitis. It might serve as a less toxic alternative to intravenous foscavir.