Monitoring of human herpesviruses after allogeneic peripheral blood stem cell transplantation and bone marrow transplantation

Br J Haematol. 1999 Apr;105(1):295-302.

Abstract

Herpesviruses frequently cause serious complications after allogeneic bone marrow transplantation (allo-BMT). Recent studies have shown more rapid immune reconstitution after allogeneic peripheral blood stem cell transplantation (allo-PBSCT) compared with allo-BMT. However, it has not been clarified whether the improved immune reconstitution after allo-PBSCT is associated with a lower incidence of herpesvirus infections. We monitored the emergence of Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6) and HHV-7 DNA by a nested-double polymerase chain reaction in peripheral blood leucocytes from 22 allo-BMT and 16 allo-PBSCT patients. Each virus had an unique temporal profile of detection. HHV-6 DNA was detected most frequently at 3 weeks after transplantation, whereas CMV and EBV DNA were detected later (2-3 months). Detection rates of HHV-6 DNA at 3 and 4 weeks after allo-BMT were significantly higher than those after allo-PBSCT (9/16 v 2/13 at 3 weeks, P < 0.01; 10/21 v 1/15 at 4 weeks, P < 0.01). Detection rates of the other three herpesviruses after the two types of allogeneic transplantation were not significantly different throughout observation period. Furthermore, detection of HHV-6 DNA within the first 4 weeks was associated with delayed platelet engraftment after both allo-BMT and allo-PBSCT (P < 0.01). These results suggest an advantage for allo-PBSCT over allo-BMT in terms of suppression of HHV-6 reactivation and prevention of subsequent complications.

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation / methods*
  • Child
  • Cytomegalovirus / isolation & purification
  • DNA, Viral / analysis
  • Female
  • Graft Survival
  • Graft vs Host Disease / virology
  • Hematologic Diseases / therapy
  • Hematologic Diseases / virology
  • Hematopoietic Stem Cell Transplantation / methods*
  • Herpesvirus 4, Human / isolation & purification*
  • Herpesvirus 6, Human / isolation & purification*
  • Herpesvirus 7, Human / isolation & purification*
  • Humans
  • Male
  • Middle Aged
  • Transplantation, Homologous

Substances

  • DNA, Viral