Chronic anemia due to parvovirus B19 infection in a bone marrow transplant patient after platelet transfusion

Cohen, B. J.; Beard, Sally; Knowles, Wendy A.; Ellis, J. S.; Joske, David; Goldman, J M; Hewitt, Patricia; Ward, Katherine N.

doi:10.1046/j.1537-2995.1997.37997454023.x

Cited by 86 publications

(58 citation statements)

References 22 publications

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“…Parvovirus B19 may infrequently be transmitted by other blood-derived products such as platelets, intravenous immunoglobulin, fibrin products and clottingfactor preparations (Cohen et al, 1997;Erdman et al, 1997;Hino et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, only four case histories have been described in which a parvovirus B19 infection was established between 5 weeks and 10 months after BMT (Weiland et al, 1989;Corbett et al, 1995;Cohen et al, 1997;Kobayashi et al, 1998). In four clinical series involving a total of 359 patients receiving a BMT, only two asymptomatic patients had serum samples positive for parvovirus B19 DNA (Frickhofen et al, 1992;Azzi et al, 1993;Soderlund et al, 1997;Gallinella et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

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Parvovirus B19 transmitted by bone marrow

Heegaard¹,

Petersen

2000

Br J Haematol

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Summary. We describe a case of symptomatic parvovirus B19 infection transmitted by bone marrow (BM). The infection caused prolonged anaemia, thrombocytopenia, arthralgia and erythema infectiosum in a 16-year-old girl with acute myeloid leukaemia receiving a BM transplant (BMT). The BM donor was a 19-year-old asymptomatic brother who had parvovirus B19 viraemia at the time of BM harvest. Sequencing of the VP2 gene from the patient and the donor showed a perfect match of DNA sequences, confirming the mode of transmission. Parvovirus B19 represents a potential complicating factor in patients undergoing BMT, but screening by polymerase chain reaction (PCR) of donor BM may reduce the risk of infection.Keywords: bone marrow, ELISA, parvovirus B19, polymerase chain reaction, transplantation.Parvovirus B19 exhibits a marked tropism to human bone marrow (BM) and replicates only in erythroid progenitor cells (Brown & Young, 1995). The virus is transmissible by the respiratory route or by blood and infection may lead to erythema infectiosum, arthropathy, hydrops fetalis and various haematological disorders (aplastic crisis, chronic anaemia, idiopathic thrombocytopenic purpura). We present the first case of symptomatic parvovirus B19 infection transmitted by BM causing prolonged anaemia, thrombocytopenia, arthralgia and erythema infectiosum. PATIENT AND METHODSA 16-year-old girl diagnosed with acute myeloid leukaemia underwent bone marrow transplantation (BMT) on 25 October 1984 (day 0). Twelve days later, she developed fever and a rash involving the upper extremities. The rash subsequently progressed, involving the lower extremities, neck and face (slapped cheek appearance). Coinciding with these findings, the patient complained of arthralgia, mainly involving the large joints. The symptoms gradually disappeared over a 3-week period.Examination of BM slides (air-dried BM inoculum) using light microscopy revealed no lantern cells or giant pronormoblasts at the time of BMT or during follow-up. Apart from red cell hypoplasia, no specific changes were noted. Reticulocytes were absent for extended periods of time (days 0±15 and 35±75) and reoccurred briefly in small numbers (days 16±34), before showing a slow but steady increase towards normal levels (day 76 onwards). Within the first 76 d, haemoglobin levels were accordingly low (5´6±11´6 g/dl), and a reduced number of platelets (5± 78 Â 10 9 /l) were observed. Transfusion of 16 units of red blood cells and 101 units of platelets were needed to sustain and correct these parameters. The patient then finished the standard protocol involving methotrexate and cyclosporin treatment and has had no adverse haematological symptoms during 15 years of follow-up.As part of a retrospective pilot study of parvovirus B19 infection in BM recipients, we tested a number of stored BM and serum samples from the patient by enzyme-linked immunosorbent assay (ELISA) and amplified the NS and VP genes by nested polymerase chain reaction (PCR) (Hornsleth et al, 1994). Examination of this material reve...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Parvovirus B19 transmitted by bone marrow

Heegaard¹,

Petersen

2000

Br J Haematol

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“…Over 8 years prior to admission, a 53-year-old man was diagnosed with chronic myelogenous leukemia after presenting with a white blood count of 180,000 cells/mm 3 .…”

Section: Case Reportmentioning

confidence: 99%

“…While it has been believed that hematopoietic cell infection with parvovirus B19 is strictly confined to the erythroid series, viral growth can also be maintained in fetal liver cell cultures, and, in a case of pancytopenia after bone marrow transplantation, the parvovirus B19 capsid antigen has been detected within giant bone marrow granulocytes [2]. Transmission of parvovirus B19 occurs primarily via respiratory secretions, although cases of transmission through blood products or bone marrow have been reported [3,4].…”

Section: Introductionmentioning

confidence: 99%

Pure red cell aplasia associated with parvovirus B19 infection occurring late after allogeneic bone marrow transplantation

et al. 2004

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Differential diagnosis for anemia late after allogeneic stem cell transplantation is broad. In this report, we describe a case of severe anemia secondary to pure red cell aplasia associated with human parvovirus B19 infection over 8 years after allogeneic bone marrow transplantation. Characteristics of parvovirus B19 infection and the immunosuppressed state after allogeneic stem cell transplantation are reviewed. Am.

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“…Se ha observado seroconversión, infección sintomática y asintomá-tica en pacientes tratados con distintos productos sanguíneos obtenidos de lotes de plasmas contaminados con B19 4,5,6 . Del mismo modo, se ha documentado la transmisión del virus e infección sintomática a través de concentrados de plaquetas provenientes de donantes 7 .…”

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Detección de ADN de parvovirus B19 en donantes de sangre de tres hospitales en Santiago, Chile

et al. 2011

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Chronic anemia due to parvovirus B19 infection in a bone marrow transplant patient after platelet transfusion

Abstract: Blood Donor A with asymptomatic acute B19 infection was the source of B19 infection in the bone marrow transplant patient. Donor B with a low level of B19 DNA was not the source of infection.

Cited by 86 publications

References 22 publications

Parvovirus B19 transmitted by bone marrow

Parvovirus B19 transmitted by bone marrow

Pure red cell aplasia associated with parvovirus B19 infection occurring late after allogeneic bone marrow transplantation

Detección de ADN de parvovirus B19 en donantes de sangre de tres hospitales en Santiago, Chile

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