Department of Hematology and Oncology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany,
Department of Hematology and Oncology, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Acta Haematol. 2021;144(2):202-211. doi: 10.1159/000509739. Epub 2020 Sep 9.
Skin rash is a first symptom of acute graft-versus-host disease (GvHD) after allogeneic stem cell transplantation (ASCT) but can also be caused by viruses. The relevance of virus DNA analyses in skin rash for diagnosis and clinical outcome is unknown.
To record the frequencies of detection of herpes and parvovirus B19 (ParvoB19) DNA in skin rash within 100 days after ASCT and to analyze their relevance for diagnosis, clinical course, and non-relapse mortality (NRM).
We retrospectively identified 55 patients with virus DNA analysis for CMV, EBV, HHV6, HHV8, HSV, VZV, or ParvoB19. We assessed the rate of virus DNA detection and studied associations with histological diagnosis, virus DNA from concomitantly analyzed blood, clinical presentation, exanthema treatment, and NRM.
CMV, EBV, HHV6, HHV8, HSV, VZV and ParvoB19 DNA were detected in 12.5, 11.8, 10, 0, 0, 2.9, and 26.7% of exanthemas. Histopathological diagnosis was not associated with virus polymerase chain reaction (PCR) results. Detection of CMV, EBV, or HHV6 DNA but not ParvoB19 in skin and blood was associated with PCR results (p = 0.016; p < 0.001; p = 0.067; p = n.a.). Detection of CMV, EBV, HHV6, or ParvoB19 DNA in the skin was not significantly associated with patient, ASCT, or GvHD characteristics. Detection of ParvoB19 but not herpes virus DNA was associated with less immunosuppressive treatment (p = 0.015) and lower NRM (p = 0.041). In multivariate analyses, detection of ParvoB19 was associated with a lower NRM.
Detection of ParvoB19 DNA in exanthema after ASCT might be associated with lower NRM.
皮疹是异基因造血干细胞移植（ASCT）后急性移植物抗宿主病（GvHD）的首发症状，但也可能由病毒引起。皮疹中病毒 DNA 分析对诊断和临床结果的相关性尚不清楚。
记录 ASCT 后 100 天内皮疹中疱疹和微小病毒 B19（ParvoB19）DNA 的检出频率，并分析其与诊断、临床病程和非复发死亡率（NRM）的相关性。
我们回顾性地确定了 55 例进行 CMV、EBV、HHV6、HHV8、HSV、VZV 或 ParvoB19 病毒 DNA 分析的患者。我们评估了病毒 DNA 的检出率，并研究了其与组织学诊断、同时分析的血液中的病毒 DNA、临床表现、皮疹治疗和 NRM 的相关性。
CMV、EBV、HHV6、HHV8、HSV、VZV 和 ParvoB19 DNA 在 12.5%、11.8%、10%、0%、0%、2.9%和 26.7%的皮疹中被检出。组织病理学诊断与病毒聚合酶链反应（PCR）结果无关。皮肤和血液中 CMV、EBV 或 HHV6 DNA 的检出与 PCR 结果相关（p=0.016;p<0.001;p=0.067;p=n.a.）。皮肤中 CMV、EBV、HHV6 或 ParvoB19 DNA 的检出与患者、ASCT 或 GvHD 特征无显著相关性。ParvoB19 DNA 的检出与较少的免疫抑制治疗（p=0.015）和较低的 NRM（p=0.041）相关，但疱疹病毒 DNA 的检出则不相关。在多变量分析中，ParvoB19 的检出与较低的 NRM 相关。
ASCT 后皮疹中 ParvoB19 DNA 的检出可能与较低的 NRM 相关。
