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Has anyone developed shingles on IM ?
Ho: Lucky me, I developed shingles this past weekend. The MD Anderson staff have seen increased incidence of shingles in patients on imatinib. See the abstract on the right.
What did you take for shingles ?
Ho : I am taking famcyclovir (antiviral) and neurontin (painkiller of sorts) regularly and vicodin (opiate painkiller) as needed. Too many pills for an absent-minded person like myself!
How does one know if they have the shingles ?
Ho: I did not realize I had shingles until several days later - I was initially more concerned that this was one of the common adverse skin reactions to imatinib. Given that shingles should be medically treated within the first 72 hours, those on imatinib should be aware of what shingles is and how to recognize it.
So what is shingles ?
Ho: Shingles is caused by reactivation of dormant virus from a previous chickenpox infection.
So who cannot get shingles ?
Ho: Those who have not had chickenpox will not develop shingles.
How does shingles develop ?
Ho: After a chickenpox infection, the virus hides in nerve cells along the spine. When opportunity arises (compromised immune system, poor health, stress, advanced age), the virus can emerge from dormancy and attack nerves and skin cells.
So what are the symptoms of shingles ?
Ho: Symptoms are flu-like symptoms and a painful, itchy rash restricted to a crescent on one side of the body (usually the torso,sometimes the face - if it occurs on the face, seek medical treatment immediately as the virus can attack the eyes).
What can be done for treatment ?
Ho: The antiviral drugs used to treat shingles are most effective when used in the first 72 hours.
The current thinking is to treat with antivirals for 7 days,starting as soon as possible (for those who are not seriously mmunocompromised). Longer treatment hasn't been shown to do anything.
Where can I found out more about shingles ?
Ho: For more information, see www.shingles.com
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Ho Leung Ng is an MD PhD CML Survivor from Berkley, CA
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Is it dangerous to have shingles ?
Ho: Shingles is usually not life-threatening but can cause long-term, severe pain in the
worst cases.
The virus infection for the majority of people is self-limited. The problem istrying to minimize the long-term or even permanent nerve damage that the virus can do while the infection is active.
Clin Cancer Res 2003 Mar;9(3):976-80
Development of Varicella-Zoster virus infection in patients with chronic myelogenous leukemia treated with imatinib mesylate.
Mattiuzzi GN, Cortes JE, Talpaz M, Reuben J, Rios MB, Shan J, Kontoyiannis D, Giles FJ, Raad I, Verstovsek S, Ferrajoli A, Kantarjian HM.
Department of Leukemia, The University of Texas M.D. Anderson Cancer Center,
1515 Holcombe Boulevard, Houston, TX 77030, USA.
gmattiuz@mdanderson.org
PURPOSE:
Infection with Varicella-Zoster virus (VZV) is an exceptionallyrare complication of chronic myelogenous leukemia (CML) without stem celltransplantation. We report 16 patients with CML who developed VZV infection during imatinib mesylate therapy.
PATIENTS AND METHODS:
From July 1998 until February 2002, 771 patients were included in 11 imatinib mesylate studies for all CML phases in the Departments of Leukemia and Bioimmunotherapy at The University of Texas M. D. Anderson Cancer Center. Sixteen patients developed VZV infection. Charts and follow-up information of were reviewed and analyzed.
RESULTS:
Sixteen patients (2%) developed a VZV infection [15 episodes of herpes zoster (HZ), 1 varicella]. The baseline characteristicsof the 16 patients with infection do not differ significantly from those who did not develop VZV infection, except for time from diagnosis of CML to imatinib (median: 55 versus 25 months, P = 0.0056) and the number of prior therapies (3 versus 1, P < 0.001). All patients received therapy with antiviral agents with good response. Six patients developed postherpetic neuralgia.
CONCLUSIONS:
Our results suggest that imatinib therapy in CML is associated with low incidence of HZ infection. VZV infection is more frequent with longer duration of CML disease and with prior therapy, does not disseminate, responds well to therapy, and does not mandate a recommendation for HZ prophylaxis in such patients.
Mariner Queries
to ask the doc
to ask doc on testing
puffy eyes, conception, IM effects
discrepancy in FISH
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