Table 1.
Clinical Characteristics of the Study Population
| Patient Characteristic | Overall no. (%) | Herpes zoster post-HCT | P Value | |
|---|---|---|---|---|
| No | Yes | |||
| Number | 1000 | 806 | 194 | |
| Median Age at HCT | 0.04 | |||
| ≤55.5 | 500 (50) | 416 (83.2) | 84 (16.8) | |
| ≥55.5 | 500 (50) | 390 (78) | 110 (22) | |
| Sex | 0.24 | |||
| Female | 376 (37.6) | 296 (78.7) | 80 (21.3) | |
| Male | 624 (62.4) | 510 (81.7) | 114 (18.3) | |
| Ethnicity | 0.54 | |||
| White | 850 (85.0) | 684 (80.5) | 166 (19.5) | |
| Non white | 94 (9.4) | 79 (84) | 15 (16) | |
| Unknown | 56 (5.6) | 43 (76.8) | 13 (23.2) | |
| Type of HCT | 0.07 | |||
| Single autologous HCT | 948 (94.8) | 759 (80.1) | 189 (19.9) | |
| Tandem autologous HCTs | 52 (5.2) | 47 (90.4) | 5 (9.6) | |
| Conditioning regimen | 0.99 | |||
| Myeloablative with TBI-based regimens |
165 (16.5) | 133 (80.6) | 32 (19.4) | |
| Myeloablative with chemotherapy | 835 (83.5) | 673 (80.6) | 162 (19.4) | |
| Status at HCT | 0.47 | |||
| Relapse | 727 (72.7) | 587 (80.7) | 140 (19.3) | |
| Remission | 208 (20.8) | 164 (78.8) | 44 (21.2) | |
| Unknown | 65 (6.5) | 55 (83.9) | 10 (16.1) | |
| Underlying Disease | 0.60 | |||
| Multiple myeloma | 347 (34.7) | 271 (78.1) | 76 (21.9) | |
| Hodgkin’s disease | 115 (11.5) | 95 (82.6) | 20 (17.4) | |
| Non-Hodgkin’s lymphoma | 414 (41.4) | 337 (81.4) | 77 (18.6) | |
| Autoimmune disease | 23 (2.3) | 18 (78.3) | 5 (21.7) | |
| Others* | 101 (10.1) | 85 (84.2) | 16 (15.8) | |
| HZ pre-HCT | 0.27 | |||
| No | 926 (92.6) | 750 (81) | 176 (19) | |
| Yes | 74 (7.4) | 56 (75.7) | 18 (24.3) | |
| Received Maintenance Therapy | 0.002 | |||
| No | 719 (71.9) | 597 (83.0) | 122 (17.0) | |
| Yes† | 281 (28.1) | 209 (74.4) | 72 (25.6) | |
| Type of Maintenance Therapy | 0.03 | |||
| Lenalidomide | 49 (4.9) | 38 (77.6) | 11 (22.4) | |
| Rituximab | 87 (8.7) | 63 (72.4) | 24 (27.6) | |
| Bortezomib | 23 (2.3) | 18 (78.2) | 5 (21.7) | |
| Other | 122 (12.2) | 90 (73.8) | 32 (26.2) | |
| None | 719 (71.9) | 597 (83) | 122 (17) | |
| Relapse | 0.98 | |||
| No | 819 (81.9) | 660 (80.6) | 159 (19.4) | |
| Yes§ | 181 (18.1) | 146 (80.7) | 35 (19.3) | |
| ALC at day 365 post-HCT¶ | 0.68 | |||
| Below Lower Quartile (<760 cells/µl) | 47 (24.4) | 34 (72.3) | 13 (27.7) | |
| Above Lower Quartile (≥760 cells/µl) | 146 (75.6) | 110 (75.3) | 36 (24.7) | |
| CD34 Selected HCT or ATG use | 0.79 | |||
| No | 967 (96.7) | 780 (80.7) | 187 (19.3) | |
| Yes | 33 (3.3) | 26 (78.8) | 7 (21.2) | |
| Duration of ACV prophylaxis after HCT | 0.02 | |||
| ≤3months | 179 (17.9) | 158 (88.3) | 21 (11.7) | |
| 3–6 months | 93 (9.3) | 78 (83.9) | 15 (16.1) | |
| 6–12 months | 380 (38.0) | 302 (79.5) | 78 (20.5) | |
| 12–24 months | 276 (27.6) | 210 (76.1) | 66 (23.9) | |
| >24 months | 72 (7.2) | 58 (80.6) | 14 (19.4) | |
| Recipient HSV serostatus | 0.29 | |||
| Positive | 779 (77.9) | 636 (81.6) | 143 (18.4) | |
| Negative | 220 (22.0) | 169 (76.8) | 51 (23.2) | |
| Equivocal | 1 (0.1) | 1 (100) | 0 (0.0) | |
| Recipient CMV serostatus | 0.25 | |||
| Positive | 547 (54.7) | 450 (82.3) | 97 (17.7) | |
| Negative | 451 (45.1) | 354 (78.5) | 97 (21.5) | |
| Equivocal | 2 (0.2) | 2 (100) | 0 (0.0) | |
| Follow up | 0.02 | |||
| Outside institution | 867 (86.7) | 709 (81.8) | 158 (18.2) | |
| SCCA/FHCRC | 133 (13.3) | 97 (72.9) | 36 (27.1) | |
Abbreviation: HCT, hematopoietic cell transplant; TBI, total body irradiation; HZ, herpes zoster; ALC, absolute lymphocyte count; ACV, acyclovir; HSV, herpes simplex; CMV, cytomegalovirus; SCCA, Seattle Cancer Care Alliance; FHCRC, Fred Hutchinson Cancer Research Center.
Other diseases included solid tumors (n=57), chronic inflammatory diseases (n=29), acute leukemia (n=10), and other lymphoproliferative diseases (n=5).
Patients receiving maintenance therapy had multiple myeloma (n=160), non-Hodgkin’s lymphoma (n=99), Hodgkin’s disease (n=8), and ‘other’ diseases (n=14).
Patients who relapsed had non-Hodgkin’s lymphoma (n=76), multiple myeloma (n=73), solid tumors (n=15), Hodgkin’s disease (n=14), and acute leukemia (n=3).
There were 193 patients with day 365 post-HCT ALC data available.