Herpes Zoster in Children with Cancer

Of 1,132 children treated for malignant neoplasias at St. Jude Children's Research Hospital, 101 developed herpes zoster. This population was studied retrospectively to determine frequency of infection, relationship to cancer therapy, clinical course, complications, and results of treatment. The incidence of infection was highest (22%) in patients with Hodgkin disease and lowest (0.7%) in patients with acute myelogenous leukemia. The overall incidence was 9%. Mortality was low in these children—3% for those with infection and 0.3% for the total population. Complications included pneumonitis, meningoencephalitis, chronic thrombocytopenia, iritis, keratitis, and progressive and prolonged cutaneous zoster. Cobalt-60 irradiation produced no significant changes in zoster incidence, and no specific chemotherapeutic drugs could be implicated as instigating factors in infection. Rates of survival and recurrence of malignant neoplasm were not affected by the presence of herpes zoster infection.