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Human herpesvirus 6 infection and transient acquired myelodysplasia in children
Author(s) -
KagialisGirard Sandrine,
Durand Brigitte,
Mialou Valérie,
Pagès MariePierre,
Galambrun Claire,
Bertrand Yves,
Negrier Claude
Publication year - 2005
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20667
Subject(s) - cytopenia , medicine , dysplasia , bone marrow , myelodysplastic syndromes , concomitant , pathology , differential diagnosis , haematopoiesis , bone marrow failure , anemia , blood cancer , immunology , cancer , biology , stem cell , genetics
Background To demonstrate that primary human herpesvirus 6 (HHV‐6) infection in childhood can cause hematopoietic dysplasia that mimics a myelodysplastic syndrome (MDS) in severe cases. Procedure Seven immunocompetent children, who presented at admission with concomitant cytopenias in blood and morphologic features of dysplasia in bone marrow, were evaluated. Diagnosis of acute HHV‐6 infection was secondary made by detection of HHV‐6 DNA in plasma, bone marrow, or cerebrospinal fluid and measurement of plasma antibody titers. Peripheral blood and bone marrow aspirate smears were examined at diagnosis and during follow‐up. Morphologic recognition of myelodysplasia was made according to the recommendations of the Third MIC Cooperative Group. Results Anemia was the most frequent cytopenia (five of seven cases). Bi‐ or tri‐lineage dysplasia was observed in the marrow samples. Granulocytic and erythroid cells were always affected with dysgranulopoiesis and dyserythropoiesis scores equal to or higher than 3. Myelodysplasia was not due to a clonal disorder and disappeared gradually within 1 or 2 months. Conclusions Our results indicate that severe HHV‐6 infection may induce reversible myelodysplastic changes. These findings contribute to elucidate the pathogenicity of HHV‐6 and furthermore suggest that HHV‐6 infection must also be considered as a cause of dysplasia in the differential diagnosis of MDS. Pediatr Blood Cancer 2006; 47:543–548. © 2005 Wiley‐Liss, Inc.