Management of herpesvirus reactivations in patients with solid tumours and hematologic malignancies: update of the Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) on herpes simplex virus type 1, herpes simplex virus type 2, and varicella zoster virus

Henze, Larissa; Buhl, Christoph; Sandherr, Michael; Cornely, Oliver A.; Heinz, Werner; Khodamoradi, Yascha; Kiderlen, Til R.; Köehler, Philipp; Seidler, Alrun; Sprute, Rosanne; Schmidt‐Hieber, Martin; Lilienfeld‐Toal, Marie von

doi:10.1007/s00277-021-04746-y

Cited by 35 publications

(22 citation statements)

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“…Antiviral prophylaxis, frequently used to prevent zoster reactivation in patients with cancer, provides another method of reducing the risk of severe COVID-19 (refs 210 , 211 ). The first trials aiming for COVID-19 prophylaxis clearly demonstrated that hydroxychloroquine is ineffective for this purpose 212 .…”

Section: Alternatives To Vaccinationmentioning

confidence: 99%

COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety

et al. 2022

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Patients with cancer have a higher risk of severe coronavirus disease (COVID-19) and associated mortality than the general population. Owing to this increased risk, patients with cancer have been prioritized for COVID-19 vaccination globally, for both primary and booster vaccinations. However, given that these patients were not included in the pivotal clinical trials, considerable uncertainty remains regarding vaccine efficacy, and the extent of humoral and cellular immune responses in these patients, as well as the risks of vaccine-related adverse events. In this Review, we summarize the current knowledge generated in studies conducted since COVID-19 vaccines first became available. We also highlight critical points that might affect vaccine efficacy in patients with cancer in the future.

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Section: Alternatives To Vaccinationmentioning

confidence: 99%

COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety

et al. 2022

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“…Multiple myeloma is with an incidence rate of 56/1000 person years known to be most at risk for HZ reactivation due to illness, but also treatment related immunocompromising conditions [ 3 ]. As most myeloma patients usually receive antineoplastic medication known to significantly elevate the risk for HZ, prophylactic application of acyclovir is standard of care [ 5 ], potentially triggering other preventive measures like vaccination. Nonetheless, of those patients being treated with these antineoplastic drugs, only 5% were vaccinated.…”

Section: Discussionmentioning

confidence: 99%

“…While incidence for HZ is 3.2 per 1000 person years in the overall population [ 4 ], this number rises to about 12 in patients with solid tumors and 31 in patients with hematological diseases [ 3 ]. Therefore, in hematological high-risk patients a HZ prophylaxis is recommended as it has been shown to provide a positive impact on mortality [ 5 ]. Specific antineoplastic or immunosuppressive medication further increases risk of VZV reactivation [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Herpes Zoster Vaccination Rates in Hematological and Oncological Patients—Stock Taking 2 Years after Market Approval

et al. 2022

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Background: Vaccinations have the potential to significantly lower the burden of disease for many major infections in the high-risk population of hematological and oncological patients. In this regard Shingrix®, an inactivated Varicella Zoster Virus vaccine, received market approval in the European Union in March 2018, after prior US approval in October 2017, and recommendations specifically state immunocompromised, including oncological, patients. As vaccination rates are considered to be poor in oncological patients, determining the current vaccination rates for Shingrix® two years after market approval is important in defining the need for intervention to bring this potentially high-impact vaccine to the patients. Methods: We analyzed data of the EVO Study to provide data for Herpes zoster vaccination rates in oncological patients. The EVO Study was an interventional study evaluating the potential of increasing vaccination rates of specified must-have vaccinations by an instructional card in the oncological setting. Numbers presented in this publication merged baseline data and follow-up data of the control group; hence data not affected by the intervention. Results: Data of 370 patients were analyzed; 21.1% with hematological malignancies and 78.9% with solid cancer. Only 3.0% were vaccinated with Shingrix®. Patients with hematological malignancy were more likely to be vaccinated than those with solid cancer (7.7 vs. 1.7%). Conclusion: Despite clear recommendations and a pressing need in the high-risk population of hematological and oncological patients, the vast majority of patients are still left without vaccine protection against Herpes zoster by Shingrix®.

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“…2,38 Herpetic virus reactivation is common in the older frail population, a systematic review by the Multinational Association of Supportive Care in Cancer /International Society of Oral Oncology showed that aciclovir is effective in preventing oral herpetic viral disease in patients with hematologic malignancies 39 prophylactic aciclovir is relatively common in clinical practice and recent guidelines support this approach. 40 Baseline human immunodeficiency virus (HIV) and hepatitis B/C serology must be checked prior to starting chemotherapy and patients with past or active hepatitis B/C should receive appropriate prophylaxis and be discussed with a hepatologist/virologist.…”

Section: Antimicrobialsmentioning

confidence: 99%