valacyclovir and Multiple-Myeloma

Topics: Acyclovir; Diagnosis, Differential; Dyspnea; Herpes Simplex; Herpesvirus 1, Human; Humans; Immunosuppressive Agents; Laryngitis; Laryngostenosis; Larynx; Male; Middle Aged; Multiple Myeloma; Tracheotomy; Treatment Outcome; Valacyclovir

Topics: Acyclovir; Aged; Antineoplastic Agents; Antiviral Agents; Bortezomib; Cohort Studies; Female; Hematopoietic Stem Cell Transplantation; Herpesvirus 3, Human; Humans; Male; Middle Aged; Multiple Myeloma; Outcome Assessment, Health Care; Time Factors; Transplantation, Autologous; Valacyclovir; Valine; Varicella Zoster Virus Infection

In patients with multiple myeloma (MM), bortezomib is associated with a significant risk of Varicella zoster virus (VZV) reactivation. There are some reports that acyclovir reduces the risk of VZV reactivation. We assessed whether VZV reactivation could be reduced by using prophylactic valacyclovir at a dose of 500 mg daily.. We retrospectively evaluated 32 patients with MM who received bortezomib and valacyclovir prophylaxis at the Kanazawa Medical University Hospital. Patients received valacyclovir prophylaxis orally at a dose of 500 mg daily, without cessation during bortezomib treatment.. The median age was 69 years (range=45-90 years). Fifteen patients were male and seventeen were female. The median bortezomib dose was 37.0 mg/m(2) (range=5.2-167.6 mg/m(2)). All patients also received corticosteroids. The median duration of valacyclovir prophylaxis was 301 days (range=24-1206 days) and the median valacyclovir dose was 150.5 g (range=12-603 g). VZV reactivation developed in only one patient during valacyclovir prophylaxis. VZV reactivation did not develop in three patients who had a past history of VZV reactivation without valacyclovir prophylaxis. Adverse events over grade 3 associated with valacyclovir were not observed.. Valacyclovir at a dose of 500 mg daily appears to be effective at preventing VZV reactivation and was well-tolerated by patients with MM who received bortezomib.

Topics: Acyclovir; Aged; Aged, 80 and over; Antineoplastic Agents; Antiviral Agents; Boronic Acids; Bortezomib; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Male; Middle Aged; Multiple Myeloma; Pyrazines; Retrospective Studies; Valacyclovir; Valine; Virus Activation