acyclovir and Hodgkin-Disease

A 10-year-old boy underwent stem cell transplant for Hodgkin's lymphoma and developed vomiting and seizure in the postoperative period. An ophthalmic referral was made from intensive care unit, to rule out papilledema. On examination, there was no papilledema in both eyes, instead there were areas of retinal necrosis with no haemorrhages or vitritis in right eye. Cerebrospinal fluid serology was negative for herpes but MRI showed hyperintensity in temporal lobe. A clinical diagnosis of progressive outer retinal necrosis (PORN) was made and fundus picture was documented with help of a smartphone and 20D lens. High-dose intravenous injection acyclovir was started and PORN lesion improved on treatment.

Topics: Acyclovir; Antiviral Agents; Bone Marrow Transplantation; Child; Diagnosis, Differential; Dose-Response Relationship, Drug; Herpesviridae Infections; Hodgkin Disease; Humans; Immunosuppressive Agents; Incidental Findings; Magnetic Resonance Imaging; Male; Necrosis; Retina; Retinal Necrosis Syndrome, Acute; Retinitis; Treatment Outcome; Virus Activation

Topics: Acyclovir; Antiviral Agents; Drug Resistance, Viral; Foscarnet; Hematopoietic Stem Cell Transplantation; Herpes Simplex; Herpesvirus 1, Human; Hodgkin Disease; Humans; Male; Middle Aged; Mouth; Treatment Outcome

The authors report a peculiar form of Hodgkin's disease that is associated with Epstein-Barr virus infection. A 16-year-old patient was admitted for an autoimmune haemolytic anaemia associated with IgG auto-immune antibodies, linked to general clinical complications, cervical adenopathies and splenomegalia. The patient underwent hemicavectomy that was not histologically investigated. The ganglionar exeresis helped to establish the histological diagnosis of Hodgkin's disease, classic form with nodular sclerosis. Tumour cells were CD30 CD15 positive and neighbouring lymphoid cells were CD3 and CD20 positive. In situ hybridation allowed the detection of Epstein-Barr virus in tumour cells. Under ABVD chemotherapy supplemented with acyclovir and initial corticotherapy, mid-treatment evolution appears to be favourable. This observation is consistent with the hypothesis that tumour cells are of B cell origin during Hodgkin's disease, together with the involvement of Epstein-Barr virus in lymphomagenesis.

Topics: Acyclovir; Adolescent; Anemia, Hemolytic, Autoimmune; Antibiotics, Antineoplastic; Antineoplastic Agents, Alkylating; Antineoplastic Agents, Phytogenic; Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Autoantibodies; Bleomycin; Dacarbazine; Doxorubicin; Epstein-Barr Virus Infections; Hodgkin Disease; Humans; Immunoglobulin G; Male; Tumor Virus Infections; Vinblastine

This brief communication focuses on aspects of a recent case report (Yonsei Med J 2005;46:425-30) on a full and sustained remission of Hodgkin's lymphoma (HL) after a single day of chemotherapy. A septic episode required stopping chemotherapy and starting amphotericin B and acyclovir. Remission evidence was seen within days of starting these. A review of research supporting the notion that amphotericin B can reactivate latent Epstein-Barr virus and thus allow acyclovir to kill infected HL cells is given. Experimental work is required to confirm or refute this possibility. If successful, amphotericin B and acyclovir treatment could be extended to other EBV-driven cancers such as Burkitt's lymphoma, nasopharyngeal carcinoma and the occasional EBV-related epithelial cancer of the breast, colon, prostate, and others.

Topics: Acyclovir; Amphotericin B; Anti-Bacterial Agents; Burkitt Lymphoma; Drug Synergism; Ganciclovir; Herpesvirus 4, Human; Hodgkin Disease; Humans; Remission Induction; Tumor Necrosis Factor-alpha; Virus Activation

Topics: Acyclovir; Adult; Aged; Aged, 80 and over; Agranulocytosis; Bacterial Infections; Breast Neoplasms; Candidiasis; Female; Herpes Zoster; Hodgkin Disease; Humans; Immunocompromised Host; Lymphoma, Non-Hodgkin; Male; Middle Aged; Neoplasms; Neutropenia

Acyclovir has become the drug of choice for prevention of visceral dissemination of Varicella-zoster virus infections in immunocompromised individuals. This article describes a 6-year-old girl taking cytotoxic therapy and radiotherapy for treatment of Hodgkin lymphoma who developed cutaneous varicella infection. Despite the early administration of acyclovir a fatal varicella pneumonia occurred and she died on the 4th day of hospitalization. Since the resistance is inducible, the increase of unresponsiveness to acyclovir in immunocompromised hosts with varicella infection is a potential risk that can cause to increase in fatalities in these patients.

Topics: Acyclovir; Chickenpox; Child; Female; Hodgkin Disease; Humans; Immunocompromised Host; Pneumonia; Radiography; Risk Factors; Treatment Outcome

Topics: Acyclovir; Adult; Aged; Breast Neoplasms; Drug Evaluation; Herpesviridae Infections; Hodgkin Disease; Humans; Lymphoma, Non-Hodgkin; Middle Aged

Eight immunosuppressed homosexual men with cytomegalovirus viremia--seven with serious bilateral retinitis, one with colitis in addition to retinitis, and one with pneumonitis only--were treated with a new acyclovir derivative, 9-(1,3-dihydroxy-2-propoxymethyl) guanine, which has excellent in-vitro activity against cytomegalovirus. All patients had virologic and clinical improvement, but substantial leukopenia developed in three patients. Both clinical relapses and viral relapses occurred frequently, usually within 30 days after cessation of treatment. 9-(1,3-Dihydroxy-2-propoxymethyl) guanine represents the first clinically and virologically effective agent for the treatment of cytomegalovirus disease, but more effective and less toxic therapeutic regimens for both acute and chronic use must be developed.

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Agranulocytosis; Antiviral Agents; Colitis; Cytomegalovirus Infections; Ganciclovir; Hodgkin Disease; Homosexuality; Humans; Male; Pneumonia, Viral; Retinitis

46 patients suffering from various malignancies (17 non Hodgkin lymphomas, 12 Hodgkin's diseases, 11 acute leukaemias, 4 myelomas, 2 carcinomas), 6 patients with haematological disorders such as ITP, SAA, myeloproliferative disease, LAS and 3 patients without preexisting disease were treated with acyclovir for herpes virus infection diagnosed by clinical means. All but 7 patients had been given intensive treatment with various cytostatic agents and/or irradiation. Most patients were treated with 1500 mg acyclovir daily for 5 to 13 days. Dosage was adjusted according to renal function and clinical response in the remaining 10 cases. 11 patients received intravenous immunoglobulins in addition. Side effects were negligible (local irritation, minimal rise in serum creatinine levels in 5 patients). All patients responded to treatment; 6 patients complained of severe neuralgia lasting for more than one month; 5 patients relapsed.

Topics: Acute Disease; Acyclovir; Adolescent; Adult; Aged; Chickenpox; Combined Modality Therapy; Female; Herpes Genitalis; Herpes Simplex; Herpes Zoster; Herpesviridae Infections; Hodgkin Disease; Humans; Keratitis, Dendritic; Leukemia; Lymphoma; Male; Middle Aged; Tumor Virus Infections

In a 54-year-old male patient suffering from Hodgkin's disease, lymphomatoid papulosis occurred. Complete clearing of the skin lesions was observed immediately after intravenously administered acyclovir. The patient had numerous relapses of his skin eruption with complete responses after each course of intravenously applied acyclovir. This striking therapeutic effect parallels reports of regression of mycosis fungoides and chronic generalized lymphadenopathy after acyclovir application. The mode of action of acyclovir in these disorders is not known. They all are characterized by involvement of the T cell system, and in all these diseases, a virus etiology has been proved or is suggested. Thus, a specific effect of acyclovir on T lymphocytes or selectively on helper T cells is discussed. Alternatively, the virustatic effect of acyclovir could be responsible for the therapeutic success.

Topics: Acyclovir; Antineoplastic Combined Chemotherapy Protocols; Hodgkin Disease; Humans; Injections, Intravenous; Male; Mechlorethamine; Middle Aged; Prednisone; Procarbazine; Skin Diseases; Vincristine

We report a case of Hodgkin's disease associated with Epstein-Barr virus (EBV) infection in a 75-year-old male. The patient was given a 5-day course of acyclovir to which he responded well, with partial resolution of the lymphoma and return to well-being. A biopsy from the lymphoma after acyclovir treatment showed a change in the histological picture with a reduction in the number of giant cells. Relationships between EBV infection and Hodgkin's lymphoma are discussed.

Topics: Acyclovir; Aged; Herpesvirus 4, Human; Hodgkin Disease; Humans; Infectious Mononucleosis; Male

Topics: Acyclovir; Female; Herpesviridae Infections; Hodgkin Disease; Humans; Leukemia; Lymphoma; Male

Thirty-two episodes of herpes simplex virus infection in four immunodeficient patients with frequent recurrences were successfully treated with oral acyclovir, one capsule five times a day for 5 days. In 23 of these episodes, the treatments were extended for 1 to 6 months using two to five capsules a day with the aim of suppressing expected recurrences. In these patients, who routinely had more than one recurrence per month before treatment, there were only six outbreaks during more than 60 patient-months of suppressive therapy. Infection always recurred after treatments were completed, but the time to recurrence was shorter after treatments with two acyclovir capsules per day than after treatments with five capsules per day (p less than 0.001).

Topics: Acyclovir; Administration, Oral; Adult; Drug Administration Schedule; Female; Herpes Simplex; Hodgkin Disease; Humans; Immunologic Deficiency Syndromes; Lupus Erythematosus, Systemic; Male; Recurrence