Main Article Content
The monitoring of HHV-6 after allogeneic hematopoietic stem cell transplantation (HSTC) has proven to be useful in preventing life-threatening complications; however, the pathogenic role of HHV-6 after autologous HSCT is not well-characterized, although viral reactivation might be responsible for significant complications even after autologous HSCT. Here we report for the first time to our knowledge the case of a patient with genomic integration of HHV-6, presenting with high titers of HHV-6 after autologous HSCT, mimicking HHV-6 reactivation. The presence of viral DNA in the follicle bulb confirmed the genomic integration and allowed the discontinuation of the antiviral treatment to the patient. This case might be helpful for discriminate HHV-6 reactivation from viral integration, thus avoiding unnecessary and potentially toxic antiviral therapy once the genomic integration is confirmed.
Downloads month by month
2. Zerr DM. Human herpesvirus 6 and central nervous system disease in hematopoietic cell transplantation. J Clin Virol. 2006;37 Suppl 1:S52-56.
3. Dulery R, Salleron J, Dewilde A, et al. Early human herpesvirus type 6 reactivation after allogeneic stem cell transplantation: a large-scale clinical study. Biol Blood Marrow Transplant. 2012;18(7):1080-1089.
4. Sashihara J, Tanaka-Taya K, Tanaka S, et al. High incidence of human herpesvirus 6 infection with a high viral load in cord blood stem cell transplant recipients. Blood. 2002;100(6):2005-2511.
5. Tormo N, Solano C, de la Cámara R, et al. An assessment of the effect of human herpesvirus-6 replication on active cytomegalovirus infection after allogeneic stem cell transplantation. Biol Blood Marrow Transplant. 2010;16(5):653-661.
6. Fule Robles JD, Cheuk DK, Ha SY, et al. Human herpesvirus types 6 and 7 infection in pediatric hematopoietic stem cell transplant recipients. Ann Transplant. 2014;19:269-276.
7. Tanaka-Taya K, Sashihara J, Kurahashi H, et al. Human herpesvirus 6 (HHV-6) is transmitted from parent to child in an integrated form and characterization of cases with chromosomally integrated HHV-6 DNA. J Med Virol. 2004;73(3):465-473.
8. Daibata M, Taguchi T, Nemoto Y, Taguchi H, Miyoshi I. Inheritance of chromosomally integrated human herpesvirus 6 DNA. Blood. 1999;94(5):1545-1549.
9. Hubacek P, Virgili A, Ward KN, et al. HHV-6 DNA throughout the tissues of two stem cell transplant patients with chromosomally integrated HHV-6 and fatal CMV pneumonitis. Br J Haematol. 2009;145(3):394-398.
10. Kamble RT, Clark DA, Leong HN, Heslop HE, Brenner MK, Carrum G. Transmission of integrated human herpesvirus-6 in allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant. 2007;40(6):563-566.
11. Musso M, Scalone R, Marcacci G, et al. Fotemustine plus etoposide, cytarabine and melphalan (FEAM) as a new conditioning regimen for lymphoma patients undergoing auto-SCT: a multicenter feasibility study. Bone Marrow Transplant. 2010;45(7):1147-1153.
12. De Pauw B, Walsh TJ, Donnelly JP, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis. 2008;46:1813-1821.
13. Kamble RT, Clark DA, Leong HN, Heslop HE, Brenner MK, Carrum G. Transmission of integrated human herpesvirus-6 in allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant. 2007;40:563-566.
14. Clark DA, Nacheva EP, Leong HN, et al. Transmission of integrated human herpesvirus 6 through stem cell transplantation: implications for laboratory diagnosis. J Infect Dis. 2006;193:912-916.
15. Purev E, Winkler T, Danner RL, et al. Engraftment of donor cells with germ-line integration of HHV6 mimics HHV6 reactivation following cord blood/haplo transplantation. Blood. 2014;124:1198-1199.
16. Passweg JR, Baldomero H, Bader P, et al. Hematopoietic stem cell transplantation in Europe 2014: more than 40 000 transplants annually. Bone Marrow Transplant. 2016;51(6):786-792.