The incidence of human parvovtrus b19 infection in bone marrow transplantation patients and its impact on transplant related morbidity and mortality

Hunuui parvovirus BI9 infection is quite common in otherwiie healthy individuals. In fact, ssI-BI9 IgG antibodiei can be obacncd in about SO S of skill subjects. However, during feral development tnasplaceMar infection mty âme Mal hydrapi fetalii and in patient bearing fcemolrtic anoaia sptaüc cntn have been observed. In immunocompmnifled patients infection by parvovinis B19 may penist, but has soar only be icponed to produce prolouaul anemia or pun rad cell anemia. Here we noon a high incideace of paivo B19 infecuoni in bone marrow tranaplant patients, whkh preceded severe and ometian btal orpa invorwnenu. Oannf the pan year (Mar 95 to Feb 96) 60 patients received bone marrow grafts. 8 patients were aatognlkd, 31 patients received grafts from sMings or near relatives and 21 patients were Itsnajlsalnil from unrelated donors. In this cohort 10 patients had cttaical evidence of viral disease and proved to be infected by patvovirns B19 on a molecular ban by means of anted PCR ranks. In S patients ciylhralemusibcen(sTdii>dillofus(tm)pnvcdBtaPCRpimveeithcrinbkdor in dermal bnptic material. 2 of thete patients finally died, showing symptoms resembling Lydl disease. In 1 patient who developed fatal heart fàttarc paivo B19 DNA was detected in the invocardmm. in another patient parvo B19-aancialed hepatitis developed, which triggered severe GVHD of the liver. In addition I patient uaaaued from his mother in 1994 developed terminil mal failure oat year after UUByUnuljor. and parvo B19 infection was evidenced by positive PCR results in renal bioptic material The overall incidence of parvo B19 infection in this cohort was 23% and the parvo B19 asncialed mortality rate 7% Despke intensive search for poanbte contaminations incradrag IV imnraoglotMline solar no soarce for parvo B19 infections has been ehddaKd. These data therefore provide evidence that severe parvo B19 infections may be more common as previously anticipated.