University of Health Sciences, Pakistan
Title: Parovirus B19 in Patients of Acute Lymphoblastic Leukemia with prolonged Cytopenia
Omer Naseem graduated from FMH college of medicine and Dentistry in 2013 and after completing is housejob from Jinnah Hospital Lahore,developed a keen interest in Hematology and Oncology.He then worked with GIZ an ngo of international repute on the “ Safe blood transfusion project” where he was involved in inspections of blood bank practices and working to enhance the safety measures involved in blood banking in Pakistan.He then enrolled in Mphil Hematology programme in University of Health Sciences Lahore in 2015 and has since then participated in mulitple workshops and seminars and is keen to further enhance his vision and skills as a future hematologist.
INTRODUCTION: Parvovirus B19 is a small DNA virus and an important cause of cytopenia(s) and suppressed erythropoiesis. It is known to replicates exclusively in erythroid progenitor cells and also known to cause suppression of megakaryocytic colonies. Persistent B19 infection tends to occur in hematological malignancies. The aim of the study was to find the frequency of parvovirus b19 infection in patients with ALL with prolonged cytopenia.
MATERIALS AND METHOD: Forty nine patients suffering from ALL were enrolled for the study. All patients had persistent prolonged cytopenia for greater than 10 days beyond the scheduled date of next chemotherapy. B19 infection was investigated by detection of viral DNA in serum by Real time PCR.
RESULTS: Among the 49 patients enrolled with ALL only 6 (12.2%) were found to be Parvovirus B19 DNA positive. The infection wasn’t suspected on clinical grounds on any of the patients. Most of the patients were males (40 male and 9 females). All the patients were cytopenic with anemia, thrombocytopenia or neutropenia.
We concluded that patients with ALL are at particular risk of persistent B19 infection. Moreover, it is important to consider B19 infection as a possible cause of unexplained cytopenia(s) in these patients. Thus screening for parvovirus B19 DNA by quantitative polymerase chain reaction in cytopenic patients with ALL is suggested.