1.
Evaluation of Dengue, Zika virus, and Chikungunya virus transmission by blood components in recipients of haematopoietic stem cell transplantation
de Oliveira, F. N., Ferreira, S. C., Nishiya, A. S., Mendrone-Junior, A., Batista, M. V., Rocha, V., Costa, S. F.
Transfusion medicine (Oxford, England). 2023
Abstract
BACKGROUND Brazil has a high prevalence of arboviruses, especially Dengue (DENV), Zika (ZKV), and Chikungunya (CHKV). OBJECTIVES To study the risk of DENV, ZKV, and CHKV transmission by blood components in the haematopoietic stem cell transplantation (HSCT) population. METHODS Prospective cohort of HSCT recipients and donors performed at the Hospital das Clinicas da FMUSP, São Paulo-Brazil. Patients were evaluated by serology and RT-PCR for DENV, ZKV, and CHKV pre-transplantation and once a week until neutrophil grafting. In positive cases (positive RT-PCR and/or serology conversion), an investigation was carried out on the blood components that the patient received to evaluate the possibility of it being transfusion transmitted. RESULTS A total of 93 patients were included during the study period. The mean age was 52 years with a predominance of males (56.9%). We considered five (5.3%) DENV cases positive by seroconversion in our study. One patient had IgM seroconversion and the other four presented IgG seroconversion to DENV. In the investigation of the blood components, 145 individual samples were analysed. None of the investigated blood components showed a positive RT-PCR. CONCLUSION We observed a low prevalence of DENV, ZKV, and CHKV in HSCT donors and recipients by serology and RT-PCR, and no case of blood transfusion transmission by RT-PCR.
2.
Impact Of Pre-Emptive Granulocyte Infusions During Febrile Neutropenia In Patients Colonized With Carbapenem Resistant Gram-Negative Bacteria Undergoing Haploidentical Transplantation
Jaiswal, S. R., Bhakuni, P., Bhagwati, G., Joy, A., Chakrabarti, A., Chakrabarti, S.
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 2019
Abstract
BACKGROUND AND METHODS We prospectively studied the impact of preemptive granulocyte infusions (pGI) in 69 patients colonized with carbapenem-resistant gram-negative bacteria (CRGNB) undergoing Haploidentical HCT, compared to a previous cohort of 33 patients who received only antimicrobials directed towards CRGNB at the onset of neutropenic fever (non-pGI group). RESULTS All patients developed neutropenic fever at a median of day +8 (range -4 to +12) after transplantation. Engraftment kinetics were similar for both groups. The median number of granulocyte infusion was 2 (range,1-7) and the median dose of granulocytes infused was 5x10(10) (range,1-30) granulocytes/infusion. The overall incidence of CRGNB blood-stream infections (BSI) was 21.2% in non-pGI group (7/33) and 17.5% (12/69), in the pGI group (p=0.8). However, the CRGNB related mortality amongst those with BSI was 100% (7/7) in non-PGI group vs 16.6% (2/12) in the PGI group (p=0.001). The day 100 (4.4% vs 24.4%, p=0.002) and 2- year non-relapse mortality (NRM) (7.5% vs 35.6%, p=0.0001) were significantly reduced in the pGI group. The overall survival at 2 years was 75.6% in the pGI group vs 21.2% in the non-PGI group (p=0.0001). CONCLUSIONS Colonization and subsequent BSI with CRGNB is associated with a high incidence of mortality in patients undergoing HCT. Pre-emptive granulocyte infusion reduced early mortality associated with CRGNB in the colonized patients undergoing PTCy based Haploidentical HCT.
3.
Prevention of transfusion-transmitted cytomegalovirus infection using leukoreduced blood components in patients receiving seronegative umbilical cord blood transplantation
Shigemura, T., Yanagisawa, R., Komori, K., Morita, D., Kurata, T., Tanaka, M., Sakashita, K., Nakazawa, Y.
Transfusion. 2019
Abstract
BACKGROUND Leukoreduced blood components have been widely implemented to prevent transfusion-transmitted cytomegalovirus (TT-CMV) in transplantation. Recent progress in leukoreduction technology has helped reduce the risk of TT-CMV in hematopoietic stem cell transplantation; however, its efficacy in umbilical cord blood transplantation (CBT) has not been systematically studied. STUDY DESIGN AND METHODS We retrospectively analyzed the incidence of CMV infection in patients treated with CBT who received prestorage leukoreduced, CMV-unselected blood components between 2007 and 2017 in a single Japanese pediatric center. Patients were monitored for CMV antigenemia at least once weekly. RESULTS In total, 71 patients treated with CBT were identified. Two patients were excluded because of unknown CMV serostatus or early death after CBT. Of the remaining 69 patients, 24 developed CMV antigenemia. Among them, 3 received granulocyte transfusions (3 of 3; 100%), 2 were infants with severe combined immunodeficiency who had been infected with CMV before CBT (2 of 2; 100%), and 19 were CMV-seropositive patients (19 of 23, 82.6%). Conversely, of the remaining 45 patients in whom CMV antigenemia did not develop, 41 were seronegative (0 of 41; 0%) and were transfused with a total of 925 leukoreduced, CMV-unselected blood components. Among the 41 patients, 9 (22%) received in vivo T-cell depletion with antithymocyte globulin. None of the patients in the seronegative group has subsequently shown evidence of CMV infection or developed CMV disease. CONCLUSION Using prestorage leukoreduction, no cases of CMV infection were detected in seronegative CBT patients. Our findings showed the safety of leukoreduction in preventing TT-CMV in this patient group.
4.
Safety of leukoreduced, cytomegalovirus (CMV)-untested components in CMV-negative allogeneic human progenitor cell transplant recipients
Nash, T., Hoffmann, S., Butch, S., Davenport, R., Cooling, L.
Transfusion. 2012;52(10):2270-2