Immune reconstitution and survival of patients with parvovirus B19 related pure red cell aplasia after haplo-PBSCT

Abstract

Parvovirus B19 (PvB19) infection and PvB19 related pure red cell aplasia (PRCA) in recipients with allogeneic hematopoietic stem cell transplantation have been reported sporadically. However, clinical studies with large sample sizes are lacking, especially in patients undergoing HLA-haploidentical peripheral blood stem cell transplantation (haplo-PBSCT). In addition, clinical features, immune reconstitution, and outcomes of these patients are not clear. We conducted a retrospective analysis of 164 patients who received haplo-PBSCT with low-dose anti-thymocyte globulin (ATG) plus low-dose posttransplant cyclophosphamide (PTCy)-based regimen as graft-versus-host disease (GVHD) prophylaxis. We analyzed the incidence of PvB19 related PRCA and compared the clinical characteristics, immune reconstitution, incidence of GVHD, relapse rate, and survival between patients with and without PvB19 related PRCA. A total of 14 (8.5%) recipients developed PvB19 related PRCA after a median of 5.3 months after haplo-PBSCT. These patients with PvB19 related PRCA had slower immune reconstitution, but similar incidences of GVHD, relapse rate, and overall survival compared with recipients without PvB19 related PRCA. PvB19 related PRCA indicated relative delayed and poor immune reconstitution of the recipients early after haplo-PBSCT. PvB19 related PRCA had no effects on GVHD, relapse, and survival.

Pure red cell aplasia and minimal residual disease conversion associated with immune reconstitution in a patient with high‐risk multiple myeloma

“…Notably, a study has suggested that patients with PvB19‐related PRCA have slower immune reconstitution after human leukocyte antigen‐haploidentical peripheral blood stem cell transplantation. 13 Another case described immune reconstitution syndrome associated with B19‐induced PRCA during highly active antiretroviral therapy. 14 Furthermore, Ye Rebecca's retrospective analysis of 177 patients with MM who underwent ASCT revealed that clonal isotype switch (CIS) was found in 39 (22%) of the cases.…”