CYTOPENIA CAUSED BY PARVOVIRUS IN AN ADULT ALL PATIENT

A young woman in maintenance therapy for acute lymphoblastic leukemia in second complete remission developed fever and a skin rash associate d with severe anemia, neutropenia and erythroblastopenia A complete re covery was obtained in 4 weeks' time after red cell transfusion i.v. i mmunoglobulin and withdrawal of the maintenance chemotherapy. Parvovir us B19 infection was demonstrated by detection of B19 DNA in the patie nt's serum using a dot-blot hybridization assay and a nested polymeras e chain reaction. Serological tests were positive for anti-B19 IgG but not for IgM. Erythroblastopenia due to parvovirus infection has alrea dy been reported in ALL patients. B19 infection should be suspected in leukemic patients if unexplained cytopenia (mainly anemia) follows an acute febrile illness. Very sensitive methods are often needed to con firm the diagnosis, since routine serological tests may be unreliable in immunocompromised patients.