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Peripheral blood stem cell transplant–related Plasmodium falciparum infection in a patient with sickle cell disease
Author(s) -
Mejia Rojelio,
Booth Garrett S.,
Fedorko Daniel P.,
Hsieh Matthew M.,
Khuu Hanh M.,
Klein Harvey G.,
Mu Jianbing,
Fahle Gary,
Nutman Thomas B.,
Su XinZhuan,
Williams Esther C.,
Flegel Willy A.,
Klion Amy
Publication year - 2012
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2012.03673.x
Subject(s) - malaria , genotyping , biology , hematopoietic stem cell transplantation , stem cell , immunology , plasmodium falciparum , parasitemia , asymptomatic , red blood cell , whole blood , serology , hematopoietic stem cell , virology , medicine , genotype , pathology , haematopoiesis , antibody , genetics , gene
BACKGROUND: Although transmission of Plasmodium falciparum (Pf) infection during red blood cell (RBC) transfusion from an infected donor has been well documented, malaria parasites are not known to infect hematopoietic stem cells. We report a case of Pf infection in a patient 11 days after peripheral blood stem cell transplant for sickle cell disease. STUDY DESIGN AND METHODS: Malaria parasites were detected in thick blood smears by Giemsa staining. Pf HRP2 antigen was measured by enzyme‐linked immunosorbent assay on whole blood and plasma. Pf DNA was detected in whole blood and stem cell retention samples by real‐time polymerase chain reaction using Pf species–specific primers and probes. Genotyping of eight Pf microsatellites was performed on genomic DNA extracted from whole blood. RESULTS: Pf was not detected by molecular, serologic, or parasitologic means in samples from the recipient until Day 11 posttransplant, coincident with the onset of symptoms. In contrast, Pf antigen was retrospectively detected in stored plasma collected 3 months before transplant from the asymptomatic donor. Pf DNA was detected in whole blood from both the donor and the recipient after transplant, and genotyping confirmed shared markers between donor and recipient Pf strains. Lookback analysis of RBC donors was negative for Pf infection. CONCLUSIONS: These findings are consistent with transmission by the stem cell product and have profound implications with respect to the screening of potential stem cell donors and recipients from malaria‐endemic regions.