Molecular Study of Parvovirus B19 Infection in Children with Acute Myeloid Leukemia

Document Type: Research Articles

Authors

1 Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Egypt.

2 Pediatric Hematology - Oncology Unit, Faculty of Medicine, Mansoura University, Egypt.

3 Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Egypt.

Abstract

Background: Parvovirus B19 is a common viral infection in children. Nearby evidences are present about its
association with acute leukemia, especially acute lymphoblast leukemia. Nevertheless, scanty reports have discussed
any role in acute myeloid leukemia (AML). Purpose: To evaluate the frequency of virological markers of B19 infection
including its DNA along with specific immunoglobulins G (IgG) and M (IgM) among children with newly diagnosed
AML. Besides, describing the clinical importance of Parvovirus B19 infection in those patients. Patients and methods:
A case-control retrospective study was conducted on 48 children recently diagnosed with AML before and during
chemotherapy induction and 60 healthy control. Specific serum IgM and IgG levels were determined by enzyme linked
immunosorbant assay (ELISA) and DNA detection by polymerase chain reaction (PCR). Results: Parvovirus DNA was
detected in 20 patients with AML. IgM was found in sera of four patients and one case had positive DNA and IgG (5%).
Patients with recent parvovirus B19 infection had a significantly reduced hemoglobin levels, RBCs counts, platelet
counts, neutrophil counts and absolute lymphocytosis (p=0.01, p=0.0001, p=0.01, p=0.02, p=0.0003, respectively).
There were no clinical findings with statistically significant association to recent infection. Half of the patients with
AML had positive PCR and/or IgM for parvovirus B19. Among children with AML under chemotherapy, there were
reduced hemoglobin levels (P=0.03), reduced platelet counts (P=0.0001) and absolute neutropenia (mean±SD, 1.200
±1.00) in those with parvovirus B19 infection. More than half of patients with parvovirus B19 (72.2%) had positive PCR
and/or IgM and 36.4% of them had positive IgG. Conclusion: This study highlights that parvovirus B19 is common
in children with AML either at diagnosis or under chemotherapy. There are no clinical manifestations that can be used
as markers for its presence, but hematological laboratory findings can provide evidence for infection in the presence
of anemia and neutropenia. Detection of parvovirus B19 by combined molecular and serological markers is required
in such patients for accurate diagnosis.

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