Elevation of HHV-6 viral load mimicking HHV-6 reactivation after second umbilical cord blood transplantation in chromosomally integrated human herpesvirus-6. Issue 10 (October 2021)

• Record Type: Journal Article
• Authors: Katagiri, Seiichiro; Akahane, Daigo; Inukai, Tatsuya; Otsuki, Shunsuke; Yamada, Arisa; Moriyama, Mitsuru; Yamada, Akiko; Asano, Michiyo; Yoshizawa, Seiichiro; Tanaka, Yuko; Furuya, Nahoko; Fujimoto, Hiroaki; Gotoh, Moritaka; Nakamura, Shigeki; Gotoh, Akihiko
• Is Part Of: Journal of infection and chemotherapy. Volume 27:Issue 10(2021)
• Page Start: 1517
• Page End: 1519
• Publication Date: 2021-10
• Subjects: Chromosomally integrated human herpesvirus-6 -- Cord blood transplantation -- HHV-6 mRNA; HHV-6 human herpesvirus-6 -- allo-HSCT allogeneic hematopoietic stem cell transplantation -- CBT umbilical cord blood transplantation -- GVHD graft versus host disease -- ciHHV-6 chromosomally integrated human herpesvirus-6 -- T-ALL acute lymphoblastic T-cell leukemia -- HR hematological remission -- PBL peripheral blood leukocyte -- FISH fluorescence in situ hybridization -- BM bone marrow -- MMF mycophenolate mofetil; Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2021.05.016
• Languages: English
• ISSNs: 1341-321X

Abstract

Abstract: Human herpesvirus-6 (HHV-6) reactivation is an important complication in patients receiving umbilical cord blood transplantation (CBT). Chromosomally integrated human herpesvirus-6 (ciHHV-6) is a condition in which the complete HHV-6 genome is integrated into the host germline genome and is transmitted in a Mendelian manner. The influence of ciHHV-6 in recipients or donors in cases of CBT is unknown. We report the first case with ciHHV-6 that received CBT twice for acute lymphoblastic T-cell leukemia. HHV-6 DNA in peripheral blood leukocytes (PBLs) was examined over time through two CBTs. After the first CBT, the HHV-6 viral load was significantly reduced by conversion to PBLs derived from the first donor. During the second CBT, an increase in HHV-6 DNA in PBLs and plasma were observed. However, HHV-6 mRNA was not detected in either the sample before 2nd CBT or at the time of HHV-6 DNA elevation. It is considered that the HHV-6 DNA detected in PBLs and plasma samples might be the HHV-6 genome released due to tissue damage. This case suggests that physicians should be aware of HHV-6 DNA variability during allogeneic hematopoietic stem cell transplantation in ciHHV-6 patients.