Effective Steroid Pulse Therapy for mitigate the acute phase symptoms of Human herpesvirus 6 encephalitis after allogenic hematopoietic stem cell transplantation: experience of two cases

Abstract

Human herpesvirus 6 (HHV-6) causes life-threatening limbic encephalitis encephalitis following allogeneic haematopoietic transplantation (HSCT). We describe two patients with post-transplant HHV-6 encephalitis who were treated with corticosteroid pulse therapy. Underlying diseases were myelodysplastic syndrome and relapsing acute myeloid leukemia. Pre-engraftment immunoreaction (PIR) was recognized before the onset of HHV-6 encephalitis in both patients. They were given antiviral agents with steroid pulse therapy, and disturbed consciousness was ameliorated, but eventually died afterwards. One patient died of cerebral vascular infarction and another of severe acute graft versus host disease (GVHD). Steroid pulse therapy may be effective for HHV-6 encephalitis following allogeneic HSCT. In addition, supportive therapy is important for improving the prognosis of HHV-6 encephalitis.