Severe hepatitis associated with varicella zoster virus infection in a patient with diffuse large B cell lymphoma treated with rituximab-CHOP chemotherapy

Akinao Okamoto, Akihiro Abe, Masataka Okamoto, Tsukane Kobayashi, Tomohiko Terazawa, Yoko Inaguma, Masutaka Tokuda, Masamitsu Yanada, Satoko Morishima, Tadaharu Kanie, Yukiya Yamamoto, Motohiro Tsuzuki, Yoshiki Akatsuka, Shuichi Mizuta, Tetsushi Yoshikawa, Nobuhiko Emi

Research output: Contribution to journalArticle

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Abstract

Severe disseminated varicella zoster virus (VZV) infection rarely occurs in patients who are not recipients of hematopoietic stem cell transplantation. This report concerns severe disseminated VZV infection in a diffuse large B cell lymphoma (DLBCL) patient treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). The patient was an 82-year-old male with DLBCL who had a history of type II diabetes mellitus. He incurred VZV infection with severe hepatitis and disseminated intravascular coagulopathy after three courses of R-CHOP. When the VZV infection occurred, anti-VZV IgG was not detected and lymphopenia was observed. We initiated treatment with acyclovir, immunoglobulin, and thrombomodulin alpha, and rescued this patient. We suggest that the use of chemotherapy for immune-suppressed elderly lymphoma patients may involve the risk of severe VZV infection.

Original languageEnglish
Pages (from-to)516-520
Number of pages5
JournalInternational Journal of Hematology
Volume96
Issue number4
DOIs
Publication statusPublished - 01-10-2012

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Human Herpesvirus 3
Lymphoma, Large B-Cell, Diffuse
Virus Diseases
Hepatitis
Drug Therapy
Thrombomodulin
Lymphopenia
Acyclovir
Hematopoietic Stem Cell Transplantation
Vincristine
Prednisolone
Doxorubicin
Cyclophosphamide
Type 2 Diabetes Mellitus
Rituximab
Immunoglobulins
Lymphoma
Immunoglobulin G

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Okamoto, Akinao ; Abe, Akihiro ; Okamoto, Masataka ; Kobayashi, Tsukane ; Terazawa, Tomohiko ; Inaguma, Yoko ; Tokuda, Masutaka ; Yanada, Masamitsu ; Morishima, Satoko ; Kanie, Tadaharu ; Yamamoto, Yukiya ; Tsuzuki, Motohiro ; Akatsuka, Yoshiki ; Mizuta, Shuichi ; Yoshikawa, Tetsushi ; Emi, Nobuhiko. / Severe hepatitis associated with varicella zoster virus infection in a patient with diffuse large B cell lymphoma treated with rituximab-CHOP chemotherapy. In: International Journal of Hematology. 2012 ; Vol. 96, No. 4. pp. 516-520.
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abstract = "Severe disseminated varicella zoster virus (VZV) infection rarely occurs in patients who are not recipients of hematopoietic stem cell transplantation. This report concerns severe disseminated VZV infection in a diffuse large B cell lymphoma (DLBCL) patient treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). The patient was an 82-year-old male with DLBCL who had a history of type II diabetes mellitus. He incurred VZV infection with severe hepatitis and disseminated intravascular coagulopathy after three courses of R-CHOP. When the VZV infection occurred, anti-VZV IgG was not detected and lymphopenia was observed. We initiated treatment with acyclovir, immunoglobulin, and thrombomodulin alpha, and rescued this patient. We suggest that the use of chemotherapy for immune-suppressed elderly lymphoma patients may involve the risk of severe VZV infection.",
author = "Akinao Okamoto and Akihiro Abe and Masataka Okamoto and Tsukane Kobayashi and Tomohiko Terazawa and Yoko Inaguma and Masutaka Tokuda and Masamitsu Yanada and Satoko Morishima and Tadaharu Kanie and Yukiya Yamamoto and Motohiro Tsuzuki and Yoshiki Akatsuka and Shuichi Mizuta and Tetsushi Yoshikawa and Nobuhiko Emi",
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Okamoto, A, Abe, A, Okamoto, M, Kobayashi, T, Terazawa, T, Inaguma, Y, Tokuda, M, Yanada, M, Morishima, S, Kanie, T, Yamamoto, Y, Tsuzuki, M, Akatsuka, Y, Mizuta, S, Yoshikawa, T & Emi, N 2012, 'Severe hepatitis associated with varicella zoster virus infection in a patient with diffuse large B cell lymphoma treated with rituximab-CHOP chemotherapy', International Journal of Hematology, vol. 96, no. 4, pp. 516-520. https://doi.org/10.1007/s12185-012-1160-4

Severe hepatitis associated with varicella zoster virus infection in a patient with diffuse large B cell lymphoma treated with rituximab-CHOP chemotherapy. / Okamoto, Akinao; Abe, Akihiro; Okamoto, Masataka; Kobayashi, Tsukane; Terazawa, Tomohiko; Inaguma, Yoko; Tokuda, Masutaka; Yanada, Masamitsu; Morishima, Satoko; Kanie, Tadaharu; Yamamoto, Yukiya; Tsuzuki, Motohiro; Akatsuka, Yoshiki; Mizuta, Shuichi; Yoshikawa, Tetsushi; Emi, Nobuhiko.

In: International Journal of Hematology, Vol. 96, No. 4, 01.10.2012, p. 516-520.

Research output: Contribution to journalArticle

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T1 - Severe hepatitis associated with varicella zoster virus infection in a patient with diffuse large B cell lymphoma treated with rituximab-CHOP chemotherapy

AU - Okamoto, Akinao

AU - Abe, Akihiro

AU - Okamoto, Masataka

AU - Kobayashi, Tsukane

AU - Terazawa, Tomohiko

AU - Inaguma, Yoko

AU - Tokuda, Masutaka

AU - Yanada, Masamitsu

AU - Morishima, Satoko

AU - Kanie, Tadaharu

AU - Yamamoto, Yukiya

AU - Tsuzuki, Motohiro

AU - Akatsuka, Yoshiki

AU - Mizuta, Shuichi

AU - Yoshikawa, Tetsushi

AU - Emi, Nobuhiko

PY - 2012/10/1

Y1 - 2012/10/1

N2 - Severe disseminated varicella zoster virus (VZV) infection rarely occurs in patients who are not recipients of hematopoietic stem cell transplantation. This report concerns severe disseminated VZV infection in a diffuse large B cell lymphoma (DLBCL) patient treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). The patient was an 82-year-old male with DLBCL who had a history of type II diabetes mellitus. He incurred VZV infection with severe hepatitis and disseminated intravascular coagulopathy after three courses of R-CHOP. When the VZV infection occurred, anti-VZV IgG was not detected and lymphopenia was observed. We initiated treatment with acyclovir, immunoglobulin, and thrombomodulin alpha, and rescued this patient. We suggest that the use of chemotherapy for immune-suppressed elderly lymphoma patients may involve the risk of severe VZV infection.

AB - Severe disseminated varicella zoster virus (VZV) infection rarely occurs in patients who are not recipients of hematopoietic stem cell transplantation. This report concerns severe disseminated VZV infection in a diffuse large B cell lymphoma (DLBCL) patient treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). The patient was an 82-year-old male with DLBCL who had a history of type II diabetes mellitus. He incurred VZV infection with severe hepatitis and disseminated intravascular coagulopathy after three courses of R-CHOP. When the VZV infection occurred, anti-VZV IgG was not detected and lymphopenia was observed. We initiated treatment with acyclovir, immunoglobulin, and thrombomodulin alpha, and rescued this patient. We suggest that the use of chemotherapy for immune-suppressed elderly lymphoma patients may involve the risk of severe VZV infection.

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