Heegaard E D, Jensen L, Hornsleth A, Schmiegelow K
Department of Clinical Microbiology, University State Hospital, Copenhagen, Denmark.
Pediatr Hematol Oncol. 1999 Jul-Aug;16(4):329-34. doi: 10.1080/088800199277155.
The authors hypothesized that parvovirus B19 with its hematotropic effects has the potential to precipitate varying forms of cytopenia in patients prior to or at the diagnosis of acute lymphoblastic leukemia (ALL). Consequently, and in view of the increasing number of cases reported, this retrospective study evaluated, for the first time, the possible role of parvovirus B19 infection in pediatric patients suffering from ALL, by investigating the frequency and clinical relevance of this infection at the time of the malignant diagnosis or, when applicable, during a phase of pre-ALL. Furthermore, a review of reported parvovirus B19 infections in pediatric ALL patients is presented. The serum of 65 consecutive pediatric patients with a diagnosis of ALL was examined for possible parvovirus B19 infection employing the polymerase chain reaction and ELISA techniques. Specific IgG was demonstrated in 30% of the patients. One patient diagnosed with pre-ALL had evidence of parvovirus B19 DNA in the serum during pancytopenia 5 months prior to the onset of ALL. The results suggest that there is an insignificant chance of finding a parvovirus B19 infection in pediatric patients with ALL at the time of diagnosis. However, parvovirus B19 infection may infrequently serve as a prodrome to ALL.
作者推测,具有嗜血性作用的细小病毒B19有可能在急性淋巴细胞白血病(ALL)患者诊断之前或诊断时引发各种形式的血细胞减少症。因此,鉴于报告的病例数量不断增加,这项回顾性研究首次通过调查这种感染在恶性诊断时或在适用情况下在ALL前期阶段的发生频率和临床相关性,评估了细小病毒B19感染在患有ALL的儿科患者中的可能作用。此外,还对儿科ALL患者中报告的细小病毒B19感染进行了综述。采用聚合酶链反应和ELISA技术对65例连续诊断为ALL的儿科患者的血清进行检测,以确定是否存在细小病毒B19感染。30%的患者检测到特异性IgG。一名诊断为ALL前期的患者在ALL发病前5个月全血细胞减少期间血清中有细小病毒B19 DNA的证据。结果表明,在诊断时患有ALL的儿科患者中发现细小病毒B19感染的可能性很小。然而,细小病毒B19感染可能很少作为ALL的前驱症状。