ABSTRACT

The polyomaviruses BK and JC virus as well as parvoviruses are emerging infections in patients with hematologic malignancies and hematopoietic cell transplant recipients. BK virus has a predilection to the urinary tract and may cause hemorrhagic cystitis and nephritis.  BK viremia appears to be an important marker and predictor for BK disease in immunocompromised patients.  No well established treatment options exist but cidofovir has been used in addition to supportive care measures.  JC virus is the cause of progressive multi-focal leukoencephalopathy in immunosuppressed patients. The optimal treatment is not defined.  There is increasing evidence that parvoviruses may also cause serious disease in immunocompromised patients, including anemia, pericarditis, myocarditis, hepatitis, pneumonitis and neurologic disease. The frequency of these complications of parvoviruses is presently poorly defined. Treatment consists of intravenous immunoglobulin; no specific antiviral treatment exists.  This chapter will review the epidemiology, disease manifestations, diagnostic and management options for polyomaviruses and parvoviruses in patients with hematologic malignancies.