HLA-mismatched CD34-selected stem cell transplant complicated by HHV-6 reactivation in the central nervous system

Y. Kawano, T. Miyazaki, T. Watanabe, A. Suzue, S. Kan-Nuki, T. Kagechi, T. Onishi, M. Kaneko, S. Kanamaru, Y. Wakata, R. Nakagawa, K. Suenaga, H. Suzuya, T. Abe, S. Nagahiro, Y. Kuroda, Y. Takaue

研究成果: ジャーナルへの寄稿学術誌査読

10 被引用数 (Scopus)

抄録

We report here a patient who suffered from PCR-confirmed human herpesvirus type 6 (HHV-6) meningoencephalitis after allogeneic purified CD34+ cell transplantation from his HLA-mismatched sibling donor, even though he had been on intense prophylaxis with i.v. ganciclovir (GCV), acyclovir (ACV) and γ-globulin containing a specific antibody against HHV-6. Serological evaluation disclosed that both the donor and recipient had IgG antibody against HHV-6 before transplantation. His blood WBC count started to transiently increase on day 10, and all blood components had decreased by day 20. He then developed a severe headache and high blood pressure, and sporadic abnormal neurological findings including nystagmus and delirium. An analysis of cerebrospinal fluid (CSF) revealed 8 cells/μl, a glucose level of 130 mg/dl and a protein level of 201 mg/dl (normal, 50 mg/dl) on day 26. At the time, HHV-6 was detected only in CSF by a PCR-based method and he was diagnosed as having meningoencephalitis due to the local reactivation of HHV-6. Although he failed to respond to high-dose therapy with ACV (60 mg/kg/day) and γ-globulin, the DNA of this virus disappeared from the CNS upon treatment with GCV (30 mg/kg/day) combined with the intraventricular infusion of α-interferon. His clinical course was further complicated with meningoencephalitis due to staphylococcus epidermidis, and he died of tentorial herniation on day 79 without the recovery of blood components. This experience may indicate that intense prophylaxis to prevent reactivation of HHV-6 in the CNS is essential for the management of such profoundly immunosuppressed patients.

本文言語英語
ページ(範囲)787-790
ページ数4
ジャーナルBone Marrow Transplantation
25
7
DOI
出版ステータス出版済み - 2000
外部発表はい

!!!All Science Journal Classification (ASJC) codes

  • 血液学
  • 移植

フィンガープリント

「HLA-mismatched CD34-selected stem cell transplant complicated by HHV-6 reactivation in the central nervous system」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル