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Bone Marrow Research
Volume 2012 (2012), Article ID 409765, 7 pages
Clinical Study

New Rising Infection: Human Herpesvirus 6 Is Frequent in Myeloma Patients Undergoing Autologous Stem Cell Transplantation after Induction Therapy with Bortezomib

1Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, P.O. Box 9602, Haifa 31096, Israel
2Unit of Infectious Diseases, Rambam Health Care Campus, P.O. Box 9602, Haifa 31096, Israel
3Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, P.O. Box 9602, Haifa 31096, Israel
4Virology Laboratory, Rambam Health Care Campus, P.O. Box 9602, Haifa 31096, Israel

Received 18 July 2012; Revised 1 November 2012; Accepted 1 November 2012

Academic Editor: Catherine Bollard

Copyright © 2012 Netanel Horowitz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Herpesvirus 6 (HHV-6) infection is a common complication during immunosuppression. Its significance for multiple myeloma (MM) patients undergoing autologous stem cell transplantation (ASCT) after treatment with novel agents affecting immune system remains undetermined. Data on 62 consecutive MM patients receiving bortezomib-dexamethasone (VD) ( ; 66%) or thalidomide-dexamethasone (TD) ( , 34%) induction, together with melphalan 200 mg/m2 autograft between 01.2005 and 09.2010, were reviewed. HHV-6 reactivation was diagnosed in patients experiencing postengraftment unexplained fever (PEUF) in the presence of any level of HHHV-6 DNA in blood. There were no statistically significant differences in patient characteristics between the groups, excluding dexamethasone dosage, which was significantly higher in patients receiving TD. Eight patients in TD and 18 in VD cohorts underwent viral screening for PEUF. HHV-6 reactivation was diagnosed in 10 patients of the entire series (16%), accounting for 35% of those screened; its incidence was 19.5% ( ) in the VD group versus 9.5% ( ) in the TD group. All patients recovered without sequelae. In conclusion, HHV-6 reactivation is relatively common after ASCT, accounting for at least a third of PEUF episodes. Further studies are warranted to investigate whether bortezomib has an impact on HHV-6 reactivation development.