Coexistence of human pegivirus infection and poor hematopoietic reconstruction in a lymphoma patient after autologous hematopoietic stem cell transplantation: A case report and literature review.

RATIONALE

Lymphoblastic lymphoma (LBL) is an exceptionally aggressive form of lymphoma. Following the achievement of complete remission through induction therapy, it is imperative to proceed with consolidation and intensive treatment, subsequently followed by hematopoietic stem cell transplantation (HSCT) at the earliest opportunity. Hepatitis G virus (HPgV), an ribonucleic acid virus transmitted via blood, also known as human pegivirus, exhibits a significantly higher positivity rate among HSCT patients compared to the general population. It is widely regarded as nonpathogenic. To date, there have been no documented cases of HPgV-1 infection leading to impaired hematopoietic reconstitution. Nonetheless, the potential for HPgV-1 infection in immunocompromised individuals warrants further case studies for a comprehensive understanding.

PATIENT CONCERNS

We present a case of B-cell lymphoblastic lymphoma (B-LBL) in an 18-year-old female who presented to our hospital with a 1-month history of right lower limb bone pain.

DIAGNOSES

B-cell lymphoblastic leukemia/lymphoma (B-LBL).

INTERVENTIONS

The patient developed HPgV-1 infection accompanied by recurrent fever and poor hematopoietic reconstitution following autologous HSCT.

OUTCOMES

Within 6 months posttransplantation, the patient's blood counts remained persistently low: white blood cells fluctuated between 0.77 and 2.65 × 109/L, hemoglobin ranged from 51 to 88 g/L, and platelets varied between 8 and 23 × 109/L. Due to pancytopenia, further consolidation chemotherapy could not be administered. The B-LBL relapsed 8 months posttransplantation, and the patient succumbed to the disease 9 months after transplantation.

LESSONS

This case report highlights a rare instance of posttransplant HPgV infection associated with poor hematopoietic recovery in a patient with B-LBL. We surmise that the impaired hematopoietic recovery may be linked to HPgV infection. However, this is a single case report, and further studies are necessary to establish a definitive association.