Document Detail


Serologic study on parvovirus b19 infection in childhood acute lymphoblastic leukemia during chemotherapy: clinical and hematologic implications.
MedLine Citation:
PMID:  12142785     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To present a first descriptive serologic study on the clinical and hematologic implications of parvovirus B19 (B19) infection in children with acute lymphoblastic leukemia from the time of initial admission until discontinuation of chemotherapy.
PATIENTS AND METHODS: Seventy-five patients were studied by polymerase chain reaction, enzyme-linked immunosorbent assay, sequencing, and immunodiffusion.
RESULTS: During the period of observation, 8% (4/48) of B19-seronegative patients seroconverted and infection triggered profound anemia and thrombocytopenia. B19-specific IgG disappeared in 26% (8/31) of B19-seropositive patients, and these patients were significantly younger and the B19 IgG titers were lower on admission compared with patients who continuously displayed B19 IgG. B19 DNA was detected in the seroconverting patients, and this helped in determining the time of infection, which coincided with a B19 epidemic in 75% (3/4) of patients. Patients typically presented with fever and myalgia; a rash, indicative of B19 infection, was observed in only one patient.
CONCLUSIONS: B19 infection was able to mimic a leukemic relapse or therapy-induced cytopenia and led to hospital admission, frequent blood sampling, renewed bone marrow aspirates, multiple transfusions of red blood cells or platelets, and cessation of maintenance chemotherapy for up to 3 weeks. The peculiar disappearance of B19-specific IgG, which could not be ascribed to a generalized low level of serum immunoglobulins, has not been previously reported. The results indicate that B19 should be assayed at diagnosis of leukemia to avoid subsequent diagnostic uncertainty, and during treatment in B19-seronegative patients exhibiting unexplained cytopenia.
Authors:
Erik D Heegaard; Kjeld Schmiegelow
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric hematology/oncology     Volume:  24     ISSN:  1077-4114     ISO Abbreviation:  J. Pediatr. Hematol. Oncol.     Publication Date:    2002 Jun-Jul
Date Detail:
Created Date:  2002-07-26     Completed Date:  2002-08-16     Revised Date:  2011-10-06    
Medline Journal Info:
Nlm Unique ID:  9505928     Medline TA:  J Pediatr Hematol Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  368-73     Citation Subset:  IM    
Affiliation:
Department of Clinical Microbiology, University State Hospital, Rigshospitalet, Copenhagen, Denmark. e.heegaard@immi.ku.dk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antibodies, Viral / blood*
Child
Child, Preschool
DNA, Viral / blood*
Enzyme-Linked Immunosorbent Assay
Female
Humans
Immunodiffusion
Immunoglobulin G / blood*
Infant
Infant, Newborn
Male
Parvoviridae Infections / diagnosis,  virology*
Parvovirus B19, Human / genetics,  immunology,  isolation & purification*
Polymerase Chain Reaction
Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis,  virology*
Prevalence
Retrospective Studies
Chemical
Reg. No./Substance:
0/Antibodies, Viral; 0/DNA, Viral; 0/Immunoglobulin G

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