Precisione Treatment for Parvovirus B19 Infection After Hematopoietic Stem Cell Transplantation: a Case Report and Review of the Literature

Abstract Background: Cytopenia due to parvovirus B19 (PVB19) infection has rarely been reported in recipients of thalassemia major after hematopoietic stem cell transplantation (HSCT). Most of the reported cases were patients undergone solid organ transplantation, especially renal transplant. However, cases of pediatric patients in thalassemia major have rarely been reported. Case presentation: Here we report a girl that had PVB19-induced anemia while undergoing immunosuppressive therapy after transplant. The patient presented with progressive anemia and had a lowest hemoglobin level of 58 g/L. Bone marrow biopsy showed suppress inhibited erythropoiesis with giant pronormoblasts. Next-generation sequencing of peripheral blood suggested the infection of PVB19.The detection of serum PVB19-DNA using quantitative polymerase chain reaction revealed a viral load of over 1×108 copies/ml. The hemoglobin level increased to 113 g/L after six courses of intravenous immunoglobulin (IVIG) therapy. Monitoring of viral load showed PVB19-DNA level remained at a low level for six months before clearance. Pure red cell aplasia was not observed during the treatment period. Conclusions: Our case suggests that timely and adequately diagnosis and treatment against PVB19 with IVIG is effective and may prevent sequential complications in pediatric HSCT recipients.