Prolonged Remission In A Child With Chronic Myeloid Leukemia Following Parvo Virus B19 (b19v) Infection
Kumar, A., Moulik, N. R., Kishore, J., Kumar, A., & Jain, A. (2015). Prolonged remission in a child with chronic myeloid leukemia following Parvo virus B19 (B19V) infection. Indian journal of medical microbiology, 33(3), 432–434. https://doi.org/10.4103/0255-0857.158580
View Original Source →Abstract
Parvovirus B19 (B19V) has been associated with a wide spectrum of clinico-pathological disorders in human beings depending upon the host immunity. The present report describes a child with chronic myeloid leukemia ( CML) on hydroxyurea in haematological remission, who developed profound erythroid suppression following B19V infection requiring multiple transfusions and withdrawal of hydroxyurea. Despite being off-therapy the child remained in complete clinical and haematological remission till anti B19V antibodies appeared. This case illustrates the ability of B19V infection in suppressing neoplastic myeloid clone, a phenomenon not described earlier.
Case Details
Disease Location
Bone marrowithblood
Personal Characteristics
7-year-old boy
Clinical Characteristics
Presented with irregular fever and abdominal distension for 6 months clinical examination, counts and bone marrow were suggestive of cml. Bcr‐abl translocation was documented on fish he attained complete clinical and haematological remission within 3 months of starting hydroxyurea. At year 4, he contracted b19v, hydroxyurea was discontinued due to severe anaemia at the age of 5 and a half, haemoglobin levels gradually improved and transfusion requirement ceased coinciding with the reappearance of myeloid precursors in the peripheral blood
Remission Characteristics
At age 4, when b19v infection was detected, a new fish did not show presence of bcr-abl translocation.
Treatment & Mechanisms
Proposed Remission Mechanisms
Virus induced cytotoxicity as well as b19v induced upregulation of ifn-gamma akin
Clinical Treatment
Hydroxyurea blood transfusion (10u)