826 ACYCLOVIR: THERAPY OF V-Z INFECTIONS IN CHILDREN WITH MALIGNANCIES

Abstract

7 immunocompromised children (4-16 yrs) whose primary diagnoses were ALL (2), Burkitt's lymphoma and Hodgkin's (2 each), Ewing's tumor (1) had primary varicella with pneumonia (2) or zoster (5). Virus isolation was attempted from all pts. and was successful in 3. Six pts. were on multiagent chemotherapy for malignancy; the 7th pt. last received chemotherapy 3 mo before zoster. Lymphopenia (<1200/mm³; mean 654/mm³) occurred in 5 of 7 children and neutropenia of 368/mm³ in 1 child. Acyclovir (ACV) therapy was administered in a dosage of 250 mg/m²/day (1 pt.), 750 mg/m²/day (2 pts.) and 1500 mg/m²/day (4 pts.) as 3 doses/day for 5 days.

All patients recovered from their infections. Vesicular lesions crusted in 1-4 days after initiation of ACV. Viral cultures were negative within 1 day of initiating therapy. There was no noted toxicity associated with ACV. There were no relapses of V-Z although cancer chemotherapy was given concomitantly in 1 pt. and resumed in 4-15 days in 6 pts. Follow-up was 4 mo (1) to 1 yr (1) and no sequelae of infection or recurrences have been noted. One Burkitt's pt. died, 1 has active Hodgkin's disease, and 5 are in remission with respect to their malignant disease.

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