{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T20:56:05Z","timestamp":1787950565422,"version":"build-2784847793"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,1,20]],"date-time":"2014-01-20T00:00:00Z","timestamp":1390176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Varicella zoster virus (<jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content>) reactivation following hematopoietic stem cell transplantation (<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content>) may cause significant morbidity and mortality. We undertook a retrospective study to determine the frequency and risk factors associated with <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content> reactivation, including underlying disease, the use of fludarabine in high\u2010risk leukemia chemotherapy protocols, and immune status before <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>We studied 163 children who underwent a first <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> between 2002 and 2008, before introduction of routine <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content> prophylaxis on our unit. <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content> diagnosis was based on clinical features and supported by polymerase chain reaction on plasma and\/or vesical fluid. Patient data and possible risk factors pre\u2010 and post <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> were recorded and compared using a multivariate regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Within this cohort, 41 (25%) patients developed <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content> reactivation during the first year after transplantation at a median of 60\u00a0days post <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content> reactivation occurred more often within the subgroup of patients with acute leukemia compared with the remainder of patients (38% vs. 15%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). Multivariate <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ox regression analysis revealed that, besides positive <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content> serology in patients pre\u2010<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.03), acute leukemia as the indication for <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> remained the only independent risk factor for <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content> reactivation (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.025, odds ratio 2.5, 95% confidence interval 1.1\u20135.6). This was associated with low pre\u2010transplant T\u2010cell counts, especially in the <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4<jats:sup>+<\/jats:sup> subset. No differences were found in relation to donor type, age, or use of serotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content> reactivation after <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> predominates in acute leukemia patients and is associated with low T <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4<jats:sup>+<\/jats:sup> lymphocyte counts. This finding demonstrates the impact of pre\u2010<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> host immune suppression on <jats:styled-content style=\"fixed-case\">VZV<\/jats:styled-content> reactivation patterns after <jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12180","type":"journal-article","created":{"date-parts":[[2014,1,20]],"date-time":"2014-01-20T06:48:22Z","timestamp":1390200502000},"page":"188-194","source":"Crossref","is-referenced-by-count":27,"title":["Varicella zoster reactivation after hematopoietic stem cell transplant in children is strongly correlated with leukemia treatment and suppression of host T\u2010lymphocyte immunity"],"prefix":"10.1111","volume":"16","author":[{"given":"C.L.","family":"Vermont","sequence":"first","affiliation":[{"name":"Department of Pediatrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.C.M.","family":"Jol\u2010van der Zijde","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Hissink Muller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.M.","family":"Ball","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.G.M.","family":"Bredius","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.C.","family":"Vossen","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.C.","family":"Lankester","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,1,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1702119"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705191"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2009.03.003"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/152.6.1172"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-198001000-00010"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2008.05.006"},{"issue":"3","key":"e_1_2_6_8_1","first-page":"277","article-title":"Varicella zoster infection after bone marrow transplantation: incidence, risk factors and complications","volume":"13","author":"Han CS","year":"1994","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1702190"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-09-3624"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-03-077644"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.2.576-580.2003"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705397"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200X.1995.tb03319.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2009.06.019"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2010.07.026"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428199509059649"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1999.01765.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.04.034"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.273"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5520(05)70312-3"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1002367"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268810003031"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e31817e4b14"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftid.12180","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.12180","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T13:17:18Z","timestamp":1696166238000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.12180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,1,20]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2014,4]]}},"alternative-id":["10.1111\/tid.12180"],"URL":"https:\/\/doi.org\/10.1111\/tid.12180","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,1,20]]}}}