CYTOMEGALOVIRUS AS A CAUSE OF PANCYTOPENIA

Citation
Gd. Almeidaporada et Jl. Ascensao, CYTOMEGALOVIRUS AS A CAUSE OF PANCYTOPENIA, Leukemia & lymphoma, 21(3-4), 1996, pp. 217-223
Citations number
59
Categorie Soggetti
Hematology
Journal title
ISSN journal
10428194
Volume
21
Issue
3-4
Year of publication
1996
Pages
217 - 223
Database
ISI
SICI code
1042-8194(1996)21:3-4<217:CAACOP>2.0.ZU;2-T
Abstract
Human cytomegalovirus, HCMV, infects most of the population by adultho od; the primary infection is often accompanied by transient neutropeni a and thrombocytopenia, and is followed by a period asymtomatic viral latency. In the setting of bone marrow transplantation, however, the i mmunosuppressed state of the recipient enables HCMV to re-activate or to infect the individual and cause serious sequelae. These range from hepatitis and gastrointestinal disease to interstitial pneumonia and h ematologic abnormalities, which are more common in the allograft setti ng. Little is currently known about the mechanisms by which HCMV cause s these hematologic abnormalities. In this review, we discuss experime ntal models which are helping investigators understand the immunology and pathology of CMV infection. We also summarize the in vivo and in v itro studies of the effects of HCMV on human hematopoiesis. Several po ssible mechanisms that could explain the deleterious effect of HCMV on human hematopoietic function include: 1) alteration of accessory cell function by inducing the production of inhibitory cytokines; 2) pertu rbation of stromal cell function resulting in a decreased production o f hematopoietic factors or by altering cell surface adhesion molecule expression; 3) by direct infection of the hematopoietic stem or progen itor cells. It is likely that the pathogenesis of this syndrome is mul tifactorial therefore requiring a broad therapeutic approach. This wou ld include the use of antiviral agents, hematopoietic growth factors a nd donor derived HCMV specific cytolytic cells.