Chronic persistent parvovirus B19 bone marrow infection resulting in transfusion-dependent pure red cell aplasia in multiple myeloma after allogeneic haematopoietic stem cell transplantation and severe graft versus host disease

Karrasch, Matthias; Hammer, Andreas; Hochhaus, Andreas; Rosée, Paul La; Petersen, Iver; Sauerbrei, Andreas; Baier, Michael; Sayer, Herbert G.; Hermann, Beate

doi:10.1080/10245332.2016.1183288

Cited by 10 publications

(4 citation statements)

References 16 publications

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“…The time of the onset of PVB19 disease range from 0.03 to 96 months after HSCT. Rash and cytopenia are the main manifestations of PVB19 infection (26/32 cases) [12][13][14][15][16], followed by other symptoms including arthralgia, malaise, headache, myalgia, and pruritus [17][18][19][20][21][22][23][24]. Four of the 32 patients developed organ failure involving the heart, the lungs, or the kidneys [21,24],among which three patients also had cytopenia.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors associated with the development of post-transplant cytopenia include the use of myelotoxic agents, viral infections, age of donors, human lymphocyte antigen compatibilities, CMV serostatuses of donor and recipient, and stem cell source [1][2][3][4][5]. Pure red cell aplasia (PRCA) caused by PVB19 infection has been sporadically reported in HSCT recipients [6]. However, cases of pediatric patients in thalassemia major have rarely been reported.…”

Section: Introductionmentioning

confidence: 99%

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Precisione Treatment for Parvovirus B19 Infection After Hematopoietic Stem Cell Transplantation: a Case Report and Review of the Literature

Zhou

Wang

et al. 2021

Preprint

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Background: Cytopenia due to parvovirus B19 (PVB19) infection has rarely been reported in recipients of thalassemia major after hematopoietic stem cell transplantation (HSCT). Most of the reported cases were patients undergone solid organ transplantation, especially renal transplant. However, cases of pediatric patients in thalassemia major have rarely been reported. Case presentation: Here we report a girl that had PVB19-induced anemia while undergoing immunosuppressive therapy after transplant. The patient presented with progressive anemia and had a lowest hemoglobin level of 58 g/L. Bone marrow biopsy showed suppress inhibited erythropoiesis with giant pronormoblasts. Next-generation sequencing of peripheral blood suggested the infection of PVB19.The detection of serum PVB19-DNA using quantitative polymerase chain reaction revealed a viral load of over 1×108 copies/ml. The hemoglobin level increased to 113 g/L after six courses of intravenous immunoglobulin (IVIG) therapy. Monitoring of viral load showed PVB19-DNA level remained at a low level for six months before clearance. Pure red cell aplasia was not observed during the treatment period. Conclusions: Our case suggests that timely and adequately diagnosis and treatment against PVB19 with IVIG is effective and may prevent sequential complications in pediatric HSCT recipients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Precisione Treatment for Parvovirus B19 Infection After Hematopoietic Stem Cell Transplantation: a Case Report and Review of the Literature

Zhou

Wang

et al. 2021

Preprint

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“…Treatment includes IVIG and cessation of immunosuppressive therapy. In some cases disease may be refractory to therapy and needs supportive management such as blood tranfusions for pure red cell aplasia …”

Section: Common Viral Infections After Allogeneic Hsctmentioning

confidence: 99%

Viral infections after allogeneic hematopoietic stem cell transplant

2019

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Viral infections are common causes of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). In particular, allogeneic HSCT induces a profound immunocompromised state that may last up to 24 months post transplant, or longer in case of chronic graft vs host disease (GVHD). The common viruses affecting HSCT patients are HSV, VZV, CMV, EBV, adenovirus, HHV6, BKvirus and upper respiratory viruses such as influenza, parainfluenza, and RSV. These infections typically occur in three distinct phases: pre-engraftment, early postengraftment, and late postengraftment. This review will have two major sections, the first will discuss the epidemiology and natural history of different viral infections and second part will discuss preventive and therapeutic strategies among HSCT patients.

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“…In addition, B19V particle is extremely small and lacks an envelope, for which it is an agent difficult to eliminate by conventional methods (detergent, extreme pH, heat, filtration) [8]. Transmission, seroconversion, symptomatic and asymptomatic infections have been documented in patients treated with different blood products obtained from plasma and platelet concentrates from apparently healthy donors [9,10,11,12,13,14].…”

Section: Introductionmentioning

confidence: 99%

Human parvovirus B19 frequency among blood donors after an epidemic outbreak: relevance of the epidemiological scenario for transfusion medicine

Adamo

Blanco

Viale

et al. 2020

Heliyon

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A retrospective, cross-sectional study was conducted to determine the frequency of human parvovirus B19 (B19V) infected individuals, viral loads and immunity among blood donors from Argentina, in a post-epidemic outbreak period. B19V DNA and specific IgG were tested in minimum study samples of donors attending a blood bank at C ordoba, Argentina, in 2014. Anti-B19V IgM and viral loads were determined in B19V-positive plasma samples. Seven of 731 samples (0.96%) resulted positive, corresponding to individuals aged 32-53 years, four of them repeat donnors and three first-time donors. Viral loads were <10 3 IU/mL. None had IgM and 6/7 had IgG, one of them at a high level (in the range of 100-200 IU/ml, and the remaining 5 at low to medium level, 5-50 IU/ml). Thus one case was classified as acute infection (DNAþ/IgM-/IgG-) and six as potentially persistent infections (DNAþ/IgM-/IgGþ). No coinfections with other pathogens of mandatory control in the pre-transfusion screening were detected. Prevalence of IgG was 77.9% (279/358). This study provides the first data of B19V prevalence in blood donors in Argentina, demonstrating high rates of acute and persistent B19V infections and high prevalence of anti-B19V IgG in a post-epidemic period. Further research is needed to elucidate mechanisms/factors for B19V persistence as well as follow-up of recipients in the context of haemo-surveillance programs, contributing to the knowledge of B19V and blood transfusion safety.

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Chronic persistent parvovirus B19 bone marrow infection resulting in transfusion-dependent pure red cell aplasia in multiple myeloma after allogeneic haematopoietic stem cell transplantation and severe graft versus host disease

Cited by 10 publications

References 16 publications

Precisione Treatment for Parvovirus B19 Infection After Hematopoietic Stem Cell Transplantation: a Case Report and Review of the Literature

Precisione Treatment for Parvovirus B19 Infection After Hematopoietic Stem Cell Transplantation: a Case Report and Review of the Literature

Viral infections after allogeneic hematopoietic stem cell transplant

Human parvovirus B19 frequency among blood donors after an epidemic outbreak: relevance of the epidemiological scenario for transfusion medicine

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