Cytosine arabinoside for localized herpes zoster in patients with cancer: failure in a controlled trial.

Cytosine arabinoside was administered in doses of 30 mg/m2 per day for three days by continuous intravenous infusion in a double-blind, placebo-controlled trial of the drug in the early management of localized herpes zoster among patients with cancer. This dose and schedule, although nontoxic, was without value in halting further development of local lesions, reducing local pain, or preventing progression to the more serious disseminated form of zoster. Herpes zoster is a frequent cause of morbidity in patients with advanced cancer [1-3], especially Hodgkin's disease; the incidence of herpes zoster was 26% in a recent study of 92 patients with Hodgkin's disease.' Although they are usually self-limited to a localized area corresponding to a sensory nerve dermatome, approximately 20% of local zoster infections in lymphoma patients will disseminate widely, occasionally producing pneumonia or encephalitis or promoting bacterial super