Varicella-zoster virus-specific cell-mediated immunity and herpes zoster development in multiple myeloma patients receiving bortezomib- or thalidomide-based chemotherapy

Ji Won Kim; Chang Ki Min; Yeung Chul Mun; Yong Park; Byung Soo Kim; Seung Hyun Nam; Youngil Koh; Ji Hyun Kwon; Pyoeng Gyun Choe; Wan Beom Park; Inho Kim

doi:10.1016/j.jcv.2015.10.018

Varicella-zoster virus-specific cell-mediated immunity and herpes zoster development in multiple myeloma patients receiving bortezomib- or thalidomide-based chemotherapy

Ji Won Kim, Chang Ki Min, Yeung Chul Mun, Yong Park, Byung Soo Kim, Seung Hyun Nam, Youngil Koh, Ji Hyun Kwon, Pyoeng Gyun Choe, Wan Beom Park, Inho Kim

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

Background: The incidence of herpes zoster is substantial during bortezomib treatment in patients with multiple myeloma (MM). Objectives: This study aimed to elucidate the effect of chemotherapy with or without bortezomib in MM patients on their herpes zoster incidence and varicella zoster virus (VZV)-specific cell-mediated immunity (CMI). Study design: Peripheral blood mononuclear cells were collected at baseline and after 1 month of bortezomib-based or thalidomide-based chemotherapy and then analyzed using VZV-specific interferon-gamma (IFN-γ) enzyme-linked immunospot (ELISPOT) assay. The clinical data from these patients were analyzed in relation to the ELISPOT results. Results: Of 58 patients analyzed, 39 patients received bortezomib and the other 19 patients, thalidomide. Among them, 5 patients developed herpes zoster during chemotherapy; all 5 were being treated with the bortezomib-based regimen and were not receiving prophylactic anti-viral agents. The median onset of herpes zoster was 32 days (range, 15-95 days) from the initiation of chemotherapy. Among patients who received bortezomib therapy, acyclovir prophylaxis significantly reduced the risk for herpes zoster (100-day cumulative incidence, 0% vs. 49.5%; p<0.001). Spot-forming cell (SFC) counts in the IFN-γ ELISPOT assay decreased from baseline after bortezomib (p=0.011) or thalidomide (p=0.096) treatment. Patients with baseline SFCs greater than 20/10⁶ mononuclear cells exhibited significantly higher incidence of herpes zoster (100-day cumulative incidence, 34.8% vs. 0%; p=0.040). Conclusions: Bortezomib treatment significantly reduced VZV-specific CMI, and high baseline SFC counts in patients receiving this treatment without acyclovir prophylaxis were associated with a significantly increased risk for herpes zoster.

Original language	English
Pages (from-to)	64-69
Number of pages	6
Journal	Journal of Clinical Virology
Volume	73
DOIs	https://doi.org/10.1016/j.jcv.2015.10.018
State	Published - 1 Dec 2015

Bibliographical note

Funding Information:
This work was supported by a grant ( No. 04-2012-0780 ) from the Seoul National University Hospital Research Fund , Seoul, Korea; a grant ( No. 0720142084 ) from the National Research Foundation of Korea , Seoul, Korea; and a grant from the Janssen Pharmaceutical Company of Johnson & Johnson , Seoul, Korea.

Publisher Copyright:
© 2015 Elsevier B.V.

Keywords

Bortezomib
Enzyme-linked immunospot assay
Herpes zoster
Multiple myeloma
Varicella-zoster virus

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jcv.2015.10.018

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Kim, J. W., Min, C. K., Mun, Y. C., Park, Y., Kim, B. S., Nam, S. H., Koh, Y., Kwon, J. H., Choe, P. G., Park, W. B., & Kim, I. (2015). Varicella-zoster virus-specific cell-mediated immunity and herpes zoster development in multiple myeloma patients receiving bortezomib- or thalidomide-based chemotherapy. Journal of Clinical Virology, 73, 64-69. https://doi.org/10.1016/j.jcv.2015.10.018

@article{e12e46be67c940d0813cfb0a9d9a7b49,

title = "Varicella-zoster virus-specific cell-mediated immunity and herpes zoster development in multiple myeloma patients receiving bortezomib- or thalidomide-based chemotherapy",

abstract = "Background: The incidence of herpes zoster is substantial during bortezomib treatment in patients with multiple myeloma (MM). Objectives: This study aimed to elucidate the effect of chemotherapy with or without bortezomib in MM patients on their herpes zoster incidence and varicella zoster virus (VZV)-specific cell-mediated immunity (CMI). Study design: Peripheral blood mononuclear cells were collected at baseline and after 1 month of bortezomib-based or thalidomide-based chemotherapy and then analyzed using VZV-specific interferon-gamma (IFN-γ) enzyme-linked immunospot (ELISPOT) assay. The clinical data from these patients were analyzed in relation to the ELISPOT results. Results: Of 58 patients analyzed, 39 patients received bortezomib and the other 19 patients, thalidomide. Among them, 5 patients developed herpes zoster during chemotherapy; all 5 were being treated with the bortezomib-based regimen and were not receiving prophylactic anti-viral agents. The median onset of herpes zoster was 32 days (range, 15-95 days) from the initiation of chemotherapy. Among patients who received bortezomib therapy, acyclovir prophylaxis significantly reduced the risk for herpes zoster (100-day cumulative incidence, 0% vs. 49.5%; p<0.001). Spot-forming cell (SFC) counts in the IFN-γ ELISPOT assay decreased from baseline after bortezomib (p=0.011) or thalidomide (p=0.096) treatment. Patients with baseline SFCs greater than 20/106 mononuclear cells exhibited significantly higher incidence of herpes zoster (100-day cumulative incidence, 34.8% vs. 0%; p=0.040). Conclusions: Bortezomib treatment significantly reduced VZV-specific CMI, and high baseline SFC counts in patients receiving this treatment without acyclovir prophylaxis were associated with a significantly increased risk for herpes zoster.",

keywords = "Bortezomib, Enzyme-linked immunospot assay, Herpes zoster, Multiple myeloma, Varicella-zoster virus",

author = "Kim, {Ji Won} and Min, {Chang Ki} and Mun, {Yeung Chul} and Yong Park and Kim, {Byung Soo} and Nam, {Seung Hyun} and Youngil Koh and Kwon, {Ji Hyun} and Choe, {Pyoeng Gyun} and Park, {Wan Beom} and Inho Kim",

note = "Funding Information: This work was supported by a grant ( No. 04-2012-0780 ) from the Seoul National University Hospital Research Fund , Seoul, Korea; a grant ( No. 0720142084 ) from the National Research Foundation of Korea , Seoul, Korea; and a grant from the Janssen Pharmaceutical Company of Johnson & Johnson , Seoul, Korea. Publisher Copyright: {\textcopyright} 2015 Elsevier B.V.",

year = "2015",

month = dec,

day = "1",

doi = "10.1016/j.jcv.2015.10.018",

language = "English",

volume = "73",

pages = "64--69",

journal = "Journal of Clinical Virology",

issn = "1386-6532",

publisher = "Elsevier B.V.",

}

Kim, JW, Min, CK, Mun, YC, Park, Y, Kim, BS, Nam, SH, Koh, Y, Kwon, JH, Choe, PG, Park, WB & Kim, I 2015, 'Varicella-zoster virus-specific cell-mediated immunity and herpes zoster development in multiple myeloma patients receiving bortezomib- or thalidomide-based chemotherapy', Journal of Clinical Virology, vol. 73, pp. 64-69. https://doi.org/10.1016/j.jcv.2015.10.018

TY - JOUR

T1 - Varicella-zoster virus-specific cell-mediated immunity and herpes zoster development in multiple myeloma patients receiving bortezomib- or thalidomide-based chemotherapy

AU - Kim, Ji Won

AU - Min, Chang Ki

AU - Mun, Yeung Chul

AU - Park, Yong

AU - Kim, Byung Soo

AU - Nam, Seung Hyun

AU - Koh, Youngil

AU - Kwon, Ji Hyun

AU - Choe, Pyoeng Gyun

AU - Park, Wan Beom

AU - Kim, Inho

N1 - Funding Information: This work was supported by a grant ( No. 04-2012-0780 ) from the Seoul National University Hospital Research Fund , Seoul, Korea; a grant ( No. 0720142084 ) from the National Research Foundation of Korea , Seoul, Korea; and a grant from the Janssen Pharmaceutical Company of Johnson & Johnson , Seoul, Korea. Publisher Copyright: © 2015 Elsevier B.V.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Background: The incidence of herpes zoster is substantial during bortezomib treatment in patients with multiple myeloma (MM). Objectives: This study aimed to elucidate the effect of chemotherapy with or without bortezomib in MM patients on their herpes zoster incidence and varicella zoster virus (VZV)-specific cell-mediated immunity (CMI). Study design: Peripheral blood mononuclear cells were collected at baseline and after 1 month of bortezomib-based or thalidomide-based chemotherapy and then analyzed using VZV-specific interferon-gamma (IFN-γ) enzyme-linked immunospot (ELISPOT) assay. The clinical data from these patients were analyzed in relation to the ELISPOT results. Results: Of 58 patients analyzed, 39 patients received bortezomib and the other 19 patients, thalidomide. Among them, 5 patients developed herpes zoster during chemotherapy; all 5 were being treated with the bortezomib-based regimen and were not receiving prophylactic anti-viral agents. The median onset of herpes zoster was 32 days (range, 15-95 days) from the initiation of chemotherapy. Among patients who received bortezomib therapy, acyclovir prophylaxis significantly reduced the risk for herpes zoster (100-day cumulative incidence, 0% vs. 49.5%; p<0.001). Spot-forming cell (SFC) counts in the IFN-γ ELISPOT assay decreased from baseline after bortezomib (p=0.011) or thalidomide (p=0.096) treatment. Patients with baseline SFCs greater than 20/106 mononuclear cells exhibited significantly higher incidence of herpes zoster (100-day cumulative incidence, 34.8% vs. 0%; p=0.040). Conclusions: Bortezomib treatment significantly reduced VZV-specific CMI, and high baseline SFC counts in patients receiving this treatment without acyclovir prophylaxis were associated with a significantly increased risk for herpes zoster.

AB - Background: The incidence of herpes zoster is substantial during bortezomib treatment in patients with multiple myeloma (MM). Objectives: This study aimed to elucidate the effect of chemotherapy with or without bortezomib in MM patients on their herpes zoster incidence and varicella zoster virus (VZV)-specific cell-mediated immunity (CMI). Study design: Peripheral blood mononuclear cells were collected at baseline and after 1 month of bortezomib-based or thalidomide-based chemotherapy and then analyzed using VZV-specific interferon-gamma (IFN-γ) enzyme-linked immunospot (ELISPOT) assay. The clinical data from these patients were analyzed in relation to the ELISPOT results. Results: Of 58 patients analyzed, 39 patients received bortezomib and the other 19 patients, thalidomide. Among them, 5 patients developed herpes zoster during chemotherapy; all 5 were being treated with the bortezomib-based regimen and were not receiving prophylactic anti-viral agents. The median onset of herpes zoster was 32 days (range, 15-95 days) from the initiation of chemotherapy. Among patients who received bortezomib therapy, acyclovir prophylaxis significantly reduced the risk for herpes zoster (100-day cumulative incidence, 0% vs. 49.5%; p<0.001). Spot-forming cell (SFC) counts in the IFN-γ ELISPOT assay decreased from baseline after bortezomib (p=0.011) or thalidomide (p=0.096) treatment. Patients with baseline SFCs greater than 20/106 mononuclear cells exhibited significantly higher incidence of herpes zoster (100-day cumulative incidence, 34.8% vs. 0%; p=0.040). Conclusions: Bortezomib treatment significantly reduced VZV-specific CMI, and high baseline SFC counts in patients receiving this treatment without acyclovir prophylaxis were associated with a significantly increased risk for herpes zoster.

KW - Bortezomib

KW - Enzyme-linked immunospot assay

KW - Herpes zoster

KW - Multiple myeloma

KW - Varicella-zoster virus

UR - http://www.scopus.com/inward/record.url?scp=84949449433&partnerID=8YFLogxK

U2 - 10.1016/j.jcv.2015.10.018

DO - 10.1016/j.jcv.2015.10.018

M3 - Article

C2 - 26546878

AN - SCOPUS:84949449433

SN - 1386-6532

VL - 73

SP - 64

EP - 69

JO - Journal of Clinical Virology

JF - Journal of Clinical Virology

ER -

Varicella-zoster virus-specific cell-mediated immunity and herpes zoster development in multiple myeloma patients receiving bortezomib- or thalidomide-based chemotherapy

Abstract

Bibliographical note

Keywords

UN SDGs

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