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Human herpesvirus 6 in hematological malignancies Ogata MJ Clin Exp Hematop 2009[Nov]; 49 (2): 57-67Pathogenetic roles of human herpesvirus (HHV)-6 in lymphoproliferative diseases have been of continued interest. Many molecular studies have tried to establish a pathogenic role for HHV-6 in lymphoid malignancies. However, whether HHV-6 plays a role in these pathologies remains unclear, as positive polymerase chain reaction results for HHV-6 in those studies may reflect latent infection or reactivation rather than presence of HHV-6 in neoplastic cells. A small number of studies have investigated HHV-6 antigen expression in pathologic specimens. As a result, the lack of HHV-6 antigen expression on neoplastic cells argues against any major pathogenic role of HHV-6. The role of HHV-6 in childhood acute lymphoblastic leukemia (ALL) has also been of interest but remains controversial, with 2 studies documenting higher levels of HHV-6 antibody in ALL patients, and another 2 large-scale studies finding no significant differences in HHV-6 seroprevalences between ALL patients and controls. Alternatively, HHV-6 is increasingly recognized as an important opportunistic pathogen. HHV-6 reactivation is common among recipients of allogeneic stem cell transplantation (SCT), and is linked to various clinical manifestations. In particular, HHV-6 encephalitis appears to be significant, life-threatening complication. Most HHV-6 encephalitis develops in patients receiving transplant from an unrelated donor, particularly cord blood, typically around the time of engraftment. Symptoms are characterized by short-term memory loss and seizures. Magnetic resonance imaging typically shows limbic encephalitis. Prognosis for HHV-6 encephalitis is poor, but appropriate prophylactic measures have not been established. Establishment of preventive strategies against HHV-6 encephalitis represents an important challenge for physicians involved with SCT.|Antigens, Viral/biosynthesis[MESH]|Encephalitis, Viral/prevention & control/transmission/*virology[MESH]|Gene Expression Regulation, Viral/physiology[MESH]|Herpesvirus 6, Human/*metabolism[MESH]|Humans[MESH]|Opportunistic Infections/prevention & control/*virology[MESH]|Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy/*virology[MESH]|Roseolovirus Infections/prevention & control/transmission/*virology[MESH]|Stem Cell Transplantation[MESH]|Transplantation, Homologous[MESH]|Virus Activation/physiology[MESH]|Virus Latency/physiology[MESH] |
