RESUMEN
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.
Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Infección por el Virus de la Varicela-Zóster , Humanos , Masculino , Femenino , Niño , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Preescolar , Herpesvirus Humano 3 , Trastornos de Fallo de la Médula Ósea/etiología , Vacunación/efectos adversos , Enfermedades de la Médula Ósea/etiología , Vacuna contra la Varicela/efectos adversos , Adolescente , Inmunoglobulinas Intravenosas/uso terapéutico , LactanteRESUMEN
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.