HHV-6-related secondary graft failure following allogeneic bone marrow transplantation.
We report the case of an 11-year-old boy who underwent allogeneic bone marrow transplantation (BMT) for relapsed acute lymphoblastic leukaemia. Despite adequate engraftment, on day 45 he developed marrow aplasia with haemophagocytosis. HHV-6 was detected in blood and bone marrow by nested PCR. Retrospective testing showed that viraemia had started on day 24. Following therapy with foscarnet and ganciclovir, viral load declined to undetectable levels and his donor marrow recovered contemporaneously. This case suggests that HHV-6 may be a treatable cause of graft failure following BMT and provides clinical and virological evidence for the anti-HHV-6 activity of ganciclovir and foscarnet.
Johnston
R E
RE
Bone Marrow Transplant Programme, Royal Free and University College Medical School, London.
Geretti
A M
AM
Prentice
H G
HG
Clark
A D
AD
Wheeler
A C
AC
Potter
M
M
Griffiths
P D
PD
D000998:Antiviral Agents / Q000627:therapeutic use; D001855:Bone Marrow Diseases / Q000821:virology; D016026:Bone Marrow Transplantation / Q000379:methods*; D002648:Child; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D006084:Graft Rejection / Q000821:virology*; D006566:Herpesviridae Infections / Q000150:complications*; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D015616:Histiocytosis, Non-Langerhans-Cell / Q000821:virology; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy / Q000821:virology; D014184:Transplantation, Homologous
D000998:Antiviral Agents; D017245:Foscarnet; D015774:Ganciclovir