Kang Jin, Wang Xuan, Bai Jiaofeng, Zhang Yuexia, Lian Bianli, Guo Yali, Mayire Ainiwaner, Pan Yaozhu
Department of Hematology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China.
The First Clinical College of Gansu University of Traditional Chinese Medicine, Lanzhou, China.
Medicine (Baltimore). 2025 Aug 22;104(34):e44133. doi: 10.1097/MD.0000000000044133.
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.
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.
B-cell lymphoblastic leukemia/lymphoma (B-LBL).
The patient developed HPgV-1 infection accompanied by recurrent fever and poor hematopoietic reconstitution following autologous HSCT.
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.
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.
淋巴细胞淋巴瘤（LBL）是一种侵袭性极强的淋巴瘤形式。通过诱导治疗实现完全缓解后，必须进行巩固和强化治疗，随后尽早进行造血干细胞移植（HSCT）。庚型肝炎病毒（HPgV）是一种通过血液传播的核糖核酸病毒，也被称为人pegivirus，与普通人群相比，HSCT患者中的阳性率显著更高。它被广泛认为是非致病性的。迄今为止，尚无HPgV - 1感染导致造血重建受损的记录病例。尽管如此，免疫功能低下个体中HPgV - 1感染的可能性仍值得进一步进行病例研究以全面了解。
我们报告一例18岁女性B细胞淋巴细胞淋巴瘤（B - LBL）病例，该患者因右下肢骨痛1个月前来我院就诊。
B细胞淋巴细胞白血病/淋巴瘤（B - LBL）。
患者在自体HSCT后发生HPgV - 1感染，伴有反复发热和造血重建不良。
移植后6个月内，患者血细胞计数持续偏低：白细胞在0.77至2.65×10⁹/L之间波动，血红蛋白在51至88 g/L之间，血小板在8至23×10⁹/L之间变化。由于全血细胞减少，无法进行进一步的巩固化疗。移植后8个月B - LBL复发，患者在移植后9个月死于该疾病。
本病例报告突出了一例罕见的移植后HPgV感染与B - LBL患者造血恢复不良相关的情况。我们推测造血恢复受损可能与HPgV感染有关。然而，这是一份单病例报告，需要进一步研究以确定明确的关联。
