Herpes zoster and varicella infections in children with Hodgkin's disease: an analysis of contributing factors

Abstract

181 children with Hodgkin's disease were analyzed with respect to the occurrence of herpes zoster and varicella (HZ-V) infections, possible contributing factors, and prognostic significance. The overall frequency of HZ-V was 34.8%. The occurrence in stage I was significantly lower than in other stages. Previous splenectomy was not found to increase significantly the risk of infection. High-risk patients were those receiving extensive radiotherapy plus combination chemotherapy; 56% developed HZ-V infections in this group. The frequency with extensive field radiotherapy alone was 23.8%. 80% of infections occurred during the first year after completion of treatment. Their occurrence was not a poor prognostic sign in terms of relapse or fatality, even when occurring late. The high frequency of disseminated infection (27%) with its subsequent morbidity should lead toward a better understanding of the immunologic deficiencies in these patients and the possible role of prophylactic measures, in patients undergoing extensive radiotherapy in combination with multiagent chemotherapy.