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Biol Blood Marrow Transplant. 2008 Aug;14(8):867-71. doi: 10.1016/j.bbmt.2008.05.006.

Varicella-zoster virus disease is more frequent after cord blood than after bone marrow transplantation.

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  • 1Groupe de Recherche en Immunologie et Transplantation de Sang de Cordon, Service d'Hématologie-Oncologie, Centre de Cancérologie Charles-Bruneau, Montréal, Québec, Canada.


Immune reconstitution may differ following cord blood transplantation (CBT) and bone marrow transplantation (BMT), and this may lead to a difference in varicella zoster virus (VZV) disease rates. One hundred fourteen VZV seropositive children received a CBT (37 patients), or a T-replete BMT (77 patients) at our institution. Patients did not received specific VZV disease prophylaxis. VZV disease was diagnosed by immunofluorescence or culture in 41 (36%) patients. In multivariate analysis, VZV disease was more frequent in older children (relative risk [RR] 1.11 per year; 95% confidence interval [CI], 1.04-1.18; P = .002), and after CBT (RR 2.27; 95% CI, 1.18-4.34; P = .013). The cumulative incidence of VZV disease at 3 years posttransplant was 46% following CBT. VZV disease incidence was 71% in CBT patients over 10 years old at transplant. Visceral dissemination occurred in 7 patients (6 CBT and 1 BMT) (P = .005). VZV disease is thus more frequent and more severe after CBT than after BMT.

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