Table 1
Clinical, haematological, and genetic data, along with B19 markers and serum cytokines on four cases of new onset of parvovirus B19 associated acute leukaemia
| Case 1 | Case 2 | Case 3 | Case 4 | |||||
|---|---|---|---|---|---|---|---|---|
| *Blood taken three months before the diagnosis of common ALL. †Blood taken before administration of blood products. | ||||||||
| ALL, acute lymphoblastic leukaemia; CNS, central nervous system; CSF, cerebrospinal fluid; GM-CSF, granulocyte–macrophage colony stimulating factor; Hb, haemoglobin; IFN, interferon; IL, interleukin; MCP, macrophage chemoattractant protein; NT, not tested; TNF, tumour necrosis factor; WCC, white cell count. | ||||||||
| Age | 7 years 2 months | 6 years 11 months | 2 years 3 months | 1 year 6 months | ||||
| Sex | F | F | M | F | ||||
| Diagnosis | Common ALL | Common ALL | Null cell ALL | M7 AML | ||||
| Clinical details | 4 week history of pallor and scalp swelling | 5 week history of flitting polyarthralgia, tiredness, lethargy, fever; 3 day history of rash; pallor, purpura, lymphadenopathy, hepatosplenomegaly | 3 week history of cough, lethargy, fever and pallor; lymphadenopathy, hepatosplenomegaly | 5 week history of unwell, pallor, rash, anorexia, weight loss, leg pain; upper respiratory tract infection, and pancytopenia 2 weeks ago; pallor, fever, purpura, hepatosplenomegaly | ||||
| CNS disease | No | No | No | No | ||||
| Hb | 5.4* | 3.0 | 5.5† | 4.2 | ||||
| WCC | 2.3* | 17 | 60 (neutropenia)† | 1.1 | ||||
| Platelets | 130* | 11 | 411† | 58 | ||||
| CSF leucocytes/protein | Normal | Normal | Normal | Normal | ||||
| Peripheral blood smear | Lymphoblasts | Lymphoblasts | Lymphoblasts | Myeloblasts | ||||
| Bone marrow | Lymphoblasts—CD10+, CD19+ | Lymphoblasts—CD10+, CD19+ | Lymphoblasts | Myeloblasts | ||||
| Cytogenetics | 53XX,+X,+6,+14,+17,+18,+21,+21/46XX | 50−52XX,+X,+4, +14,+21,+21 [cp9]/46XX 1 | 46XY | 50XX+3,+8,+9,+der(14)t(1:14)(q21:q32)3/ 46XX17 | ||||
| HLA-DR | *07 | *07/*12 | *15/*16 | *0401/*0701 | ||||
| Treatment | UKALL ‘97 | UKALL ‘97 | UKALL ‘97 | AML 12 | ||||
| Outcome | Remission | Remission | Death during chemotherapy owing to bacterial sepsis, 7 months after starting chemotherapy | Death due to AML relapse | ||||
| B19 markers | ||||||||
| Specimen | CSF | CSF | Serum | Serum | CSF | Serum | CSF | Serum |
| Days after diagnosis of leukaemia | 1 | 3 | 15 | 22 | 3 | 29 | 1 | 6 |
| NS1 gene | + | + | − | − | + | − | + | − |
| VP1 gene | NT | + | + | − | + | − | − | − |
| VP1/2 IgM | − | − | +/− | +/− | − | + | − | +/− |
| VP1/2 IgG | + | + | + | + | + | + | + | + |
| NS1 IgG | + | − | + | + | − | − | − | + |
| Serum cytokines (pg/ml) | ||||||||
| TNFα | NT | 3.59 | 126.18 | 15.74 | ||||
| IFNγ | NT | 14.83 | 41.18 | 15.94 | ||||
| IL-1β | NT | – | – | – | ||||
| IL-5 | NT | – | – | – | ||||
| IL-6 | NT | 1904.91 | 33.45 | 750.40 | ||||
| IL-13 | NT | – | – | – | ||||
| GM-CSF | NT | 3800.06 | 69.81 | 34.93 | ||||
| MCP-1 | NT | 138.61 | 107.48 | 24.98 | ||||
