RESUMO
We report 5 children with bone marrow failure (BMF) after primary varicella zoster virus (VZV) infection or VZV vaccination, highlighting the highly variable course. Two patients were treated with intravenous immunoglobulins; one had a slow hematologic recovery, and the other was rescued by allogeneic hematopoietic stem cell transplantation (HSCT). Of the 2 patients treated with immunosuppressive therapy with antithymocyte globulin and cyclosporine, one had a complete response, and the other was transplanted for nonresponse. One patient underwent a primary allograft. All patients are alive. This study demonstrated that VZV-associated BMF is a life-threatening disorder that often requires HSCT.
Assuntos
Transplante de Células-Tronco Hematopoéticas , Infecção pelo Vírus da Varicela-Zoster , Humanos , Masculino , Feminino , Criança , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Pré-Escolar , Herpesvirus Humano 3 , Transtornos da Insuficiência da Medula Óssea/etiologia , Vacinação/efeitos adversos , Doenças da Medula Óssea/etiologia , Vacina contra Varicela/efeitos adversos , Adolescente , Imunoglobulinas Intravenosas/uso terapêutico , LactenteRESUMO
Lomustine is an oral chemotherapy drug commonly used in pediatric neuro-oncology. We report on a 15-year-old formerly healthy boy, who was erroneously prescribed lomustine instead of an antibiotic for tonsillitis. He subsequently suffered from prolonged bone marrow aplasia with secondary fever in neutropenia and ubiquitous bleeding. Bone marrow regeneration started approximately 7 weeks after lomustine intake. No other permanent organ damage has been detected thus far. Oral chemotherapeutic drugs should only be prescribed by experts and dispensed in the smallest possible pack size.