Successful treatment of life-threatening human herpesvirus-6 encephalitis with donor lymphocyte infusion in a patient who had undergone human leukocyte antigen-haploidentical nonmyeloablative stem cell transplantation.
BACKGROUND
Encephalitis as the result of human herpesvirus (HHV)-6 is usually fatal when it is resistant to antiviral drugs.


METHODS
We describe a patient who developed HHV-6 encephalitis after human leukocyte antigen-haploidentical transplantation using a reduced intensity regimen.


RESULTS
The patient developed severe disorientation, amnesia, and tremors on day 28. Magnetic resonance imaging of the brain revealed limbic encephalitis, and the cerebrospinal fluid sample was positive for only HHV-6 in polymerase chain reaction analysis. Neither ganciclovir nor foscarnet was effective. The patient recovered from the critical condition of HHV-6 encephalitis after donor lymphocyte infusion (DLI). Almost all of his symptoms resolved, polymerase chain reaction tests for HHV-6 in the cerebrospinal fluid were negative, and magnetic resonance imaging findings were normal.


CONCLUSIONS
This is the first report of DLI as a treatment for HHV-6 encephalitis and the first report of DLI from an human leukocyte antigen-haploidentical donor as a treatment for life-threatening viral infection.
Yoshihara
Satoshi
S
Department of Molecular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Kato
Ruri
R
Inoue
Takayuki
T
Miyagawa
Hiromi
H
Sashihara
Junji
J
Kawakami
Manabu
M
Ikegame
Kazuhiro
K
Oka
Yoshihiro
Y
Sugiyama
Haruo
H
Kawase
Ichiro
I
Ogawa
Hiroyasu
H
D000328:Adult; D001921:Brain / Q000473:pathology / Q000821:virology; D018792:Encephalitis, Viral / Q000628:therapy*; D006086:Graft vs Host Disease / Q000517:prevention & control; D006680:HLA Antigens / Q000276:immunology*; D015654:Herpesvirus 6, Human; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017710:Lymphocyte Transfusion; D016393:Lymphoma, B-Cell / Q000473:pathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D019349:Roseolovirus Infections / Q000276:immunology* / Q000628:therapy*; D033581:Stem Cell Transplantation; D016559:Tacrolimus / Q000627:therapeutic use; D014019:Tissue Donors
D006680:HLA Antigens; D007166:Immunosuppressive Agents; D016559:Tacrolimus