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Persistent parvovirus B19 infection resulting in red cell aplasia after allogeneic hematopoietic stem cell transplantation
Authors:Y. Koda  T. Mori  J. Kato  S. Kohashi  T. Kikuchi  T. Mitsuhashi  M. Murata  T. Uemura  M. Handa  S. Okamoto
Affiliation:1. Division of Hematology, Department of Medicine, Keio University School of Medicine, , Tokyo, Japan;2. Department of Laboratory Medicine, Keio University School of Medicine, , Tokyo, Japan;3. Department of Transfusion and Cell Therapy, Keio University Hospital, , Tokyo, Japan
Abstract:Persistent parvovirus B19 (PVB) infection has been reported sporadically in immunocompromised patients including hematopoietic stem cell and solid organ transplant recipients. However, the pathogenesis of persistent infection has yet to be fully elucidated. We report here a patient with multiple myeloma developing red cell aplasia during the hematopoietic recovery after allogeneic hematopoietic stem cell transplantation (HSCT) caused by PVB. The patient had already had PVB viremia before transplantation and remained asymptomatic. The route of PVB transmission was considered to be direct contact with the patient's family member with primary PVB infection 1 month before transplantation. Treatment with intravenous immunoglobulin resulted in prompt resolution of anemia. These findings suggest that monitoring of PVB DNA is recommended for patients undergoing HSCT and having contact with individuals with documented PVB infection, even if they are asymptomatic.
Keywords:parvovirus B19  persistent infection  red cell aplasia  allogeneic hematopoietic stem cell transplantation  multiple myeloma
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