Abstract
BACKGROUND: Acute Lymphoblastic Leukemia (ALL) is a common childhood blood cancer. Human Parvovirus B19 (PV-B19) mainly replicates in bone marrow erythroblasts and can persist long after initial infection. ALL patients frequently exhibit PV-B19 viremia, arising from either viral reactivation or coincidental infection amid acute leukemia. Aims of the Study: This study aimed to determine the prevalence PV-B19 infection in ALL patients, investigate its association with hematological parameters at presentation, and monitor these parameters and disease progression in relation to PV-B19 infection. PATIENTS AND METHODS: This case-control study included 30 newly diagnosed acute lymphoblastic leukemia patients and 30 healthy blood donors as controls. Patients' data were collected through interviews or records. Plasma levels of anti-PV-B19 IgG and IgM antibodies were assessed by enzyme-linked immunosorbent assay (ELISA), and viral DNA quantification was performed using quantitative polymerase chain reaction (qPCR). RESULTS: The IgG and IgM prevalence in patients was 36.67% and 3.33%, respectively, compared to 33.33% and 0% in controls. The molecular assay revealed 63.33% of patients were PV-B19 DNA positive, significantly higher than the 6.67% in controls. Patients had a significantly higher mean log10 viral load (5.17±1.39 copies/ml) than controls (2.64± 0.28 copies/ml) (P= 0.019). PV-B19 had no significant association with hematological parameters before chemotherapy; however, after chemotherapy, viral infection was significantly associated with reduced chemotherapy response and increased blood transfusion rate. CONCLUSIONS: PV-B19 infection seems to have more pronounce role in ALL after treatment initiation, where it associates with increased rate of blood transfusion and reduced response to chemotherapy. Therefore, PV-B19 should be considered in acute leukemia patients.