Investigation of JC Virus Positivity By Real-time Polymerase Chain Reaction in Patients with Hematopoietic Stem Cell Transplant

Introduction: In immunocompromised hosts, JC virus (JCV) can reactivate and cause a lytic infection of oligodendrocytes, resulting in progressive multifocal leukoencephalopathy (PML). Bone marrow is an important reservoir and possible site of neurotropic transformation for JCV. The aim of this retrospective study was to investigate the prevalance of JCV infection by real-time polymerase chain reaction (PCR) in patients sent from bone marrow transplant service to the laboratory in our hospital. Materials and Methods: A total of 153 clinical samples obtained from 62 patients with hematopoietic stem cell transplant between December 2013 and April 2018 were included into the study. Viral nucleic acids were extracted from the samples with QIAamp DSP Virus Kit in EZ1 Advanced (Qiagen, Germany) device. Isolated viral DNA was amplified with Real Star (R) JCV PCR Kit in Rotor-GeneQ (Altona, Germany) and JCV DNA was detected with qualitative method. Results: Sixty-two patients, 35 (56.5%) males and 27 (43.5%) females, between 18 years and 71 years of age were included into the study. Total JCV DNA positivity rate was found as 11.1% (17/153). Patients' diagnosis was respectively as follows: 45.2% acute myeloid leukemia, 19.4% acute lymphoblastic leukemia, 9.7% multiple myeloma. 6.4% myeloblastic sendrome, 6.4% non-Hodgkin lymphoma, 6.4% Hodgkin lymphoma, and 6.4% anemia. The distribution of JCV DNA positivity rates was found respectively as 40% acute myeloid leukemia, 30% multiple myeloma, 10% Hodgkin lymphoma, 10% acute lymphoblastic leukemia and 10% Non-hodgkin lymphoma. It was observed that 50% of JCV DNA positive patients died in the follow-up period after hematopoietic stem cell transplantation. Conclusion: It is not possible to diagnose JCV infections clinically because they are usually asymptomatic. However, up to 90% of those diagnosed with PML die within the first six months receiving a diagnosis. Detection and clinical surveillance JCV DNA by real-time PCR for hematopoietic stem cell transplantation patients is important for early diagnosis and treatment.