Multiplex PCR for Virus Infections after Allogeneic Hematopoietic Stem Cell Transplantation

Background: Viral infections following hematopoietic stem cell transplantation (HSCT) are thought to occur due to breakdown of both cell-mediated and humoral immunity. We used a multiplex polymerase chain reaction (PCR) method to detect 13 different viral infections from before to six weeks after transplantation.

Methods: One hundred and five patients who underwent allogeneic HSCT between September 2010 and December 2012 were included. Weekly blood samples were collected from prior to transplantation to 42 days after transplantation. We used whole blood for comprehensive analysis for the following 13 viruses; herpes simplex virus 1 (HSV-1); HSV-2 varicella-zoster virus (VZV); Epstein-Barr virus (EBV); cytomegalovirus (CMV); human herpesvirus 6 (HHV-6); HHV-7; HHV-8; Adeno virus (ADV); BK virus (BKV); JC virus (JCV); parvovirus; and hepatitis B virus (HBV).

Results: Viruses were detected in 75 (71.4%) patients. Before transplantation, four types of viruses were detected in 12 patients. The detection rate gradually increased following transplantation; the number of patients having at least one type of virus peaked at 45 (45.5%) on post-transplant day 21. The most frequently detected virus during the HSCT courses was HHV6 (n=63; 60.0%), followed by EBV and CMV (n=11 each; 10.5%). No other viruses were detected. Viral infections were significantly more common among patients undergoing CBT, those with HLA mismatched HSCT, those treated with either steroids, and those with GVHD. EBV infection tended to be more common in children than in adults. No sex- or pretreatment-related differences were observed in the viral infection rate.

Conclusion: These results suggest that in the presence of these factors, we should pay attention to the increased risk of viral infection.