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Primary infection of human herpesvirus-6 in an infant who received cord blood SCT

Bone Marrow Transplantation volume 43, pages 83–84 (2009)Cite this article

Human herpesvirus-6 (HHV-6) is the etiological agent in most patients with a primary exanthem subitum infection, and it is often reactivated in immunosuppressed patients following hematopoietic stem cell transplantation (HSCT).1, 2 We report a female infant with ALL who developed primary HHV-6 infection during the early phase of allogeneic cord blood stem cell transplantation (CBSCT). The patient developed vesiculobullous eruptions that were indistinguishable from the skin lesions of acute GVHD. She was diagnosed with primary HHV-6 infection by virus isolation from the peripheral blood and detection of HHV-6 using the PCR. She was successfully treated with ganciclovir.

A 2-month-old female infant was admitted with a 2-day history of fever. She was born at 39 weeks' gestation and weighed 3.0 kg. Her family history was unremarkable; there was no evidence of consanguinity. On admission, physical examination revealed conjunctival pallor and hepatosplenomegaly. Laboratory findings were: WBC count 26.8 × 109 per liter (L1 blasts, 95%), hemoglobin 6.1 g per 100 ml, platelet count 323 × 109 per liter, C-reactive protein 11 mg per 100 ml, lactate dehydrogenase 626 IU/l (normal range: 119–229) and uric acid 6.8 mg per 100 ml (normal range: 2.3–7.0). She was diagnosed with ALL based on her BM specimen that had 85.5% CD10−, CD19+ and HLA-DR+ lymphoblastic cells. Karyotype analysis of the blast cells showed 46, XX, t(4;11)(q21;q23). Mixed-lineage leukemia (MLL) gene rearrangement was confirmed on FISH and Southern blotting. MLL/AF4 fusion gene mRNA was detected using the reverse transcriptase–PCR.

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Authors and Affiliations

  1. Department of Pediatrics, Nagoya University Graduate School of Medicine, Aichi, Japan

    H Muramatsu & S Kojima

  2. Department of Pediatric Hematology/Oncology, Japanese Red Cross Nagoya First Hospital, Aichi, Japan

    H Muramatsu, N Watanabe, K Matsumoto & K Kato

  3. Department of Pathology, Japanese Red Cross Nagoya First Hospital, Aichi, Japan

    M Ito

  4. Department of Pediatrics, Fujita Health University School of Medicine, Aichi, Japan

    T Yoshikawa

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  1. H Muramatsu
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  2. N Watanabe
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  3. K Matsumoto
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  4. M Ito
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  5. T Yoshikawa
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  6. K Kato
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  7. S Kojima
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Correspondence to H Muramatsu.

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Muramatsu, H., Watanabe, N., Matsumoto, K. et al. Primary infection of human herpesvirus-6 in an infant who received cord blood SCT. Bone Marrow Transplant 43, 83–84 (2009). https://doi.org/10.1038/bmt.2008.268

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