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Lymphotropic herpesviruses in allogeneic bone marrow transplantation
FZ Wang, H Dahl, A Linde, M Brytting, A Ehrnst and P Ljungman
Department of Medicine, Huddinge University Hospital, Sweden.
Human herpesvirus-6 (HHV-6), human herpesvirus-7 (HHV-7), Epstein-Barr
virus (EBV), and human cytomegalovirus (CMV) DNA were repeatedly assayed in
peripheral blood leukocytes from 37 allogeneic bone marrow transplant (BMT)
patients by polymerase chain reaction. Before BMT, HHV- 6 DNA was detected
in 8 (22%) patients. HHV-7, EBV, and CMV DNA were detected in 21 (57%), 10
(27%), and 1 (3%) patient, respectively. After BMT, HHV-6 DNA was detected
in 26 (70%), HHV-7 in 21 (57%), EBV in 28 (76%), and CMV in 21 (57%)
patients. Thirty-two (87%) patients were positive with more than one virus.
HHV-6, HHV-7, and EBV DNA were found earlier than CMV DNA in most patients
after BMT. The proportions of HHV- 6-positive samples during the first 3
months after BMT were higher in the patients with either delayed
granulocyte engraftment (P = .04, Fisher's exact test) or delayed platelet
engraftment (P = .001, Fisher's exact test). The HHV-6 DNA in samples from
the patients with delayed engraftment was confirmed to be variant B. The
detection of any lymphotropic herpesvirus was not related to the
development of acute graft-versus-host disease (aGVHD). High-dose acyclovir
(ACV) prophylaxis significantly (P < .01) reduced the proportion of
HHV-6- positive samples and tended to lower HHV-6 DNA levels (P = .06). Our
data indicate that HHV-6 variant B can inhibit marrow engraftment and that
high-dose ACV may be beneficial to engraftment after BMT by preventing
HHV-6 reactivation. No relation between the proportions of HHV-7-, EBV-,
and CMV-positive samples in the first 3 months and engraftment or aGVHD was
found.
Volume 88,
Issue 9,
pp. 3615-3620,
11/01/1996
Copyright © 1996 by The American Society of Hematology
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