Discussion
neutropenic
Our study clearly and concisely shows that acyclovir prophylaxis effectively reduces the incidence of HSV-1 reactivation and CIOM in HSV-seropositive autologous HSCT recipients during the neutropenic phase.Earlier studies in the 1990s mostly reported that oral HSV reactivation was not a major etiologic factor for CIOM [HSCT recipients have the highest incidence of CIOM among patients with HM [We are aware of some limitations in our study. First, we used an open-label design. We chose not to employ blinding for two specific reasons: first, to facilitate patient enrollment. Second, to enhance the comfort of patients in the control group. We though that being aware of their allocation to the control group could potentially help prevent any unnecessary delays in the therapeutic (i.e., not prophylactic) use of acyclovir if needed. However, we cannot deny that blinding of treatment groups by using placebo would have made the results even stronger. Second, some may argue that if many centers are already doing acyclovir prophylaxis in autologous HSCT recipients, the impact of this study is lessened. However, our study clearly showed HSV as a predominant factor for CIOM in modern HSCT equipped with strong anti-bacterial and fungal prophylaxis as well as adding solid evidence for clinical practice. Finally, we selected 400 mg 