Parvovirus B19 transmitted by bone marrow

We describe a case of symptomatic parvovirus B19 infection transmitted by bone marrow (BM). The infection caused prolonged anaemia, thrombocytopenia, arthralgia and erythema infectiosum in a 16-year-old girl with acute myeloid leukaemia receiving a BM transplant (BMT). The BM donor was a 19-year-old asymptomatic brother who had parvovirus B19 viraemia at the time of BM harvest. Sequencing of the VP2 gene from the patient and the donor showed a perfect match of DNA sequences, confirming the mode of transmission. Parvovirus B19 represents a potential complicating factor in patients undergoing BMT, but screening by polymerase chain reaction (PCR) of donor BM may reduce the risk of infection. (C) 2000 Blackwell Science Ltd.; References: 1 Ang, H.A., Apperley, J.F. [amp] Ward, K.N. (1997) Persistence of antibody to human parvovirus B19 after allogeneic bone marrow transplantation[colon] role of prior recipient immunity. Blood, 89, 4646[ndash]4651. 2 Azzi, A., Fanci, R., Ciappi, S., Zakrzewska, K. [amp] Bosi, A. (1993) Human parvovirus B19 infection in bone marrow transplantation patients. American Journal of Hematology, 44, 207[ndash]209. 3 Brown, K.E. [amp] Young, N.S. (1995) Parvovirus B19 infection and hematopoiesis. Blood Review, 9, 176[ndash]182. 4 Cohen, B.J., Beard, S., Knowles, W.A., Ellis, J.S., Joske, D., Goldman, J.M., Hewitt, P. [amp] Ward, K.N. (1997) Chronic anemia due to parvovirus B19 infection in a bone marrow transplant patient after platelet transfusion. Transfusion, 37, 947[ndash]952. 5 Corbett, T.J., Saw, H., Popat, U., MacMahon, E., Cohen, B.J., Knowles, W.A., Beard, S. [amp] Prentice, H.G. (1995) Successful treatment of parvovirus B19 infection and red cell aplasia occurring after an allogeneic bone marrow transplant. Bone Marrow Transplantation, 16, 711[ndash]713. 6 Erdman, D.D., Usher, M.J., Tsou, C., Caul, E.O., Gary, G.W., Kajigaya, S., Young, N.S. [amp] Anderson, L.J. (1991) Human parvovirus B19 specific IgG, IgA, and IgM antibodies and DNA in serum specimens from persons with erythema infectiosum. Journal of Medical Virology, 35, 110[ndash]115. 7 Erdman, D.D., Anderson, B.C., Torok, T.J., Finkel, T.H. [amp] Anderson, L.J. (1997) Possible transmission of parvovirus B19 from intravenous immune globulin. Journal of Medical Virology, 53, 233[ndash]236. 8 Frickhofen, N., Arnold, R., Hertenstein, B., Wiesneth, M. [amp] Young, N.S. (1992) Parvovirus B19 infection and bone marrow transplantation. Annals of Hematology, 64, A121[ndash]A124. 9 Gallinella, G., Manaresi, E., Venturoli, S., Grazi, G.L., Musiani, M. [amp] Zerbini, M. (1999) Occurrence and clinical role of active parvovirus B19 infection in transplant recipients. European Journal of Clinical Microbiology and Infectious Diseases, 18, 811[ndash]813. 10 Hino, M., Ishiko, O., Honda, K.I., Yamane, T., Ohta, K., Takubo, T. [amp] Tatsumi, N. (2000) Transmission of symptomatic parvovirus B19 infection by fibrin sealant used during surgery. British Journal of Haematology, 108, 194[ndash]195. 11 Hornsleth, A., Carlsen, K.M., Christensen, L.S., Gundestrup, M., Heegaard, E.D. [amp] Myhre, J. (1994) Estimation of serum concentration of parvovirus B19 DNA by PCR in patients with chronic anaemia. Research in Virology, 145, 379[ndash]386. 12 Jordan, J., Tiangco, B., Kiss, J. [amp] Koch, W. (1998) Human parvovirus B19[colon] prevalence of viral DNA in volunteer blood donors and clinical outcomes of transfusion recipients. Vox Sanguinis, 75, 97[ndash]102. 13 Kobayashi, S., Maruta, A., Yamamoto, T., Katayama, N., Higuchi, R., Sakano, Y., Fujita, H., Koharazawa, H., Tomita, N., Taguchi, J., Kodama, F., Nakamura, Y. [amp] Shimizu, A. (1998) Human parvovirus B19 capsid antigen in granulocytes in parvovirus-B19-induced pancytopenia after bone marrow transplantation. Acta Haematologica, 100, 195[ndash]199. 14 Shade, R.O., Blundell, M.C., Cotmore, S.F., Tattersall, P. [amp] Astell, C.R. (1986) Nucleotide sequence and genome organization of human parvovirus B19 isolated from the serum of a child during aplastic crisis. Journal of Virology, 58, 921[ndash]936. 15 Soderlund, M., Ruutu, P., Ruutu, T., Asikainen, K., Franssila, R. [amp] Hedman, K. (1997) Primary and secondary infections by human parvovirus B19 following bone marrow transplantation[colon] characterization by PCR and B-cell molecular immunology. Scandinavian Journal of Infectious Diseases, 29, 129[ndash]135. 16 Weiland, H.T., Salimans, M.M., Fibbe, W.E., Kluin, P.M. [amp] Cohen, B.J. (1989) Prolonged parvovirus B19 infection with severe anaemia in a bone marrow transplant patient (letter). British Journal of Haematology, 71, 300.