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Annals of Oncology Advance Access originally published online on January 12, 2006
Annals of Oncology 2006 17(7):1051-1059; doi:10.1093/annonc/mdj132
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© 2006 European Society for Medical Oncology

review

Antiviral prophylaxis in patients with haematological malignancies and solid tumours: Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Oncology (DGHO)

M. Sandherr1,*, H. Einsele3, H. Hebart4, C. Kahl5, W. Kern6, M. Kiehl7, G. Massenkeil8, O. Penack9, X. Schiel10, S. Schuettrumpf11, A. J. Ullmann12 and O. A. Cornely2

1 Medizinische Klinik, Klinikum Augsburg; 2 Klinik I für Innere Medizin, Hämatologie – Onkologie – Infektiologie, Klinikum der Universität zu Köln; 3 Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg; 4 Klinikum Schwäbisch Gmünd, Zentrum für Innere Medizin; 5 Abteilung Haematologie und Onkologie, Klinik und Poliklinik für Innere Medizin, Universität Rostock; 6 Universitätsklinik Freiburg; 7 Klinik für Innere Medizin, Klinikum Frankfurt (Oder); 8 Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Charite – Campus Virchow Klinikum – Berlin; 9 Medizinische Klinik III, Charite – Campus Benjamin-Franklin – Berlin; 10 Medizinische Klinik und Poliklinik III, Klinikum der Universität München-Grosshadern; 11 Zentrum Innere Medizin – Abteilung Hämatologie und Onkologie, Georg-August Universität Göttingen; 12 Klinikum Johannes Gutenberg-Universität, III. Medizinische Klinik und Poliklinik, Mainz, Germany

* Correspondence to: Dr M. Sandherr, II. Medizinische Klinik, Klinikum Augsburg, Postfach 10 19 20, 86009 Augsburg, Germany. Tel: +49 821–400–2704; Fax: +49 821–400–4812. E-mail: michael.sandherr{at}lrz.tum.de

Morbidity and mortality in patients with malignancies are increased by viral infections. These mostly are reactivations of asymptomatic latent infections. They primarily concern clinical entities associated with the reactivation of herpes viruses, such as varicella zoster virus (VZV) and cytomegalovirus (CMV). Respiratory tract infections caused by influenza, parainfluenza or respiratory syncytial virus (RSV) are less common. Since reactivation of latent infections has major clinical impact, antiviral prophylaxis is an attractive approach for patients expecting immunosuppression. The main risk factor for clinically relevant reactivation is profound disruption of cellular immune response. Duration and severity of chemotherapy induced neutropenia are of lesser importance. The risk of viral complications rises significantly in the presence of sustained suppression of T-cell function, e.g. in recipients of allogeneic stem cell transplants or of alemtuzumab (Campath-1H) antibody therapy. The objective of this guideline is to review the basis of prophylactic strategies and to provide recommendations for clinicians treating patients with haematological malignancies and solid tumors.

Key words: guidelines, antiviral prophylaxis, solid tumour, infection


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J. C. Wade
Viral Infections in Patients with Hematological Malignancies
Hematology, January 1, 2006; 2006(1): 368 - 374.
[Abstract] [Full Text] [PDF]


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