Case report: Unexpected parvovirus B19 infection in a myeloma patient treated with daratumumab

Marianna Palazzo, Gaia Ciolli, S. Pilerci, I. Attucci, L. Pengue, A. Vannucchi, E. Antonioli
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Abstract

Multiple myeloma patients have an increased risk of infections due to both the inherent nature of the disease and ongoing treatment. We describe the case of a patient who was treated with daratumumab-lenalidomide-dexamethasone regimen for two years and developed a parvovirus B19 infection. The clinical picture, characterized by trilinear cytopenia, was initially attributed to anti-neoplastic treatment. Later on, when the patient’s condition worsened, an extensive diagnostic workup was applied and parvovirus B19 infection was detected by PCR. Due to the lack of effective antiviral drugs, the patient received IV immunoglobulins and it took 10 days to achieve a decrease in viral copies. Physicians should be aware that recent changes in the therapeutic scenario of multiple myeloma would make patients more susceptible to atypical infections in this patient setting.
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病例报告:一名接受达拉单抗治疗的骨髓瘤患者发生意外细小病毒B19感染
多发性骨髓瘤患者由于疾病的固有性质和持续治疗,感染的风险增加。我们描述了一个病人的情况,他接受了达拉图单抗-来那度胺-地塞米松方案治疗两年,并发展为细小病毒B19感染。临床表现为三线形细胞减少症,最初归因于抗肿瘤治疗。后来,当患者病情恶化时,进行了广泛的诊断检查,并通过聚合酶链反应检测到细小病毒B19感染。由于缺乏有效的抗病毒药物,患者接受了静脉注射免疫球蛋白,花了10天时间才实现病毒拷贝数的减少。医生应该意识到最近多发性骨髓瘤治疗方案的变化会使患者更容易发生非典型感染。
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