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Presence of Parvovirus B19 but Not Herpesvirus Genome in Acute Skin Rash after Allogeneic Stem Cell Transplantation Correlates with Outcome.
Weber, Thomas; Schmidberger, Andreas; Ligeti, Kinga; Bauer, Marcus; Rosenwald, Andreas; Müller, Lutz P.
Afiliação
  • Weber T; Department of Hematology and Oncology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany, thomas.weber@uk-halle.de.
  • Schmidberger A; Department of Hematology and Oncology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
  • Ligeti K; Department of Hematology and Oncology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
  • Bauer M; Institute of Pathology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
  • Rosenwald A; Institute of Pathology, University Hospital Würzburg, Würzburg, Germany.
  • Müller LP; Department of Hematology and Oncology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Acta Haematol ; 144(2): 202-211, 2021.
Article em En | MEDLINE | ID: mdl-32906131
ABSTRACT

INTRODUCTION:

Skin rash is a first symptom of acute graft-versus-host disease (GvHD) after allogeneic stem cell transplantation (ASCT) but can also be caused by viruses. The relevance of virus DNA analyses in skin rash for diagnosis and clinical outcome is unknown.

OBJECTIVES:

To record the frequencies of detection of herpes and parvovirus B19 (ParvoB19) DNA in skin rash within 100 days after ASCT and to analyze their relevance for diagnosis, clinical course, and non-relapse mortality (NRM).

METHODS:

We retrospectively identified 55 patients with virus DNA analysis for CMV, EBV, HHV6, HHV8, HSV, VZV, or ParvoB19. We assessed the rate of virus DNA detection and studied associations with histological diagnosis, virus DNA from concomitantly analyzed blood, clinical presentation, exanthema treatment, and NRM.

RESULTS:

CMV, EBV, HHV6, HHV8, HSV, VZV and ParvoB19 DNA were detected in 12.5, 11.8, 10, 0, 0, 2.9, and 26.7% of exanthemas. Histopathological diagnosis was not associated with virus polymerase chain reaction (PCR) results. Detection of CMV, EBV, or HHV6 DNA but not ParvoB19 in skin and blood was associated with PCR results (p = 0.016; p < 0.001; p = 0.067; p = n.a.). Detection of CMV, EBV, HHV6, or ParvoB19 DNA in the skin was not significantly associated with patient, ASCT, or GvHD characteristics. Detection of ParvoB19 but not herpes virus DNA was associated with less immunosuppressive treatment (p = 0.015) and lower NRM (p = 0.041). In multivariate analyses, detection of ParvoB19 was associated with a lower NRM.

CONCLUSIONS:

Detection of ParvoB19 DNA in exanthema after ASCT might be associated with lower NRM.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transplante Homólogo / Parvovirus B19 Humano / Transplante de Células-Tronco Hematopoéticas / Exantema / Doença Enxerto-Hospedeiro Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transplante Homólogo / Parvovirus B19 Humano / Transplante de Células-Tronco Hematopoéticas / Exantema / Doença Enxerto-Hospedeiro Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2021 Tipo de documento: Article