Plasmodium falciparum causing hemophagocytic syndrome after allogeneic blood stem cell transplantation

TitlePlasmodium falciparum causing hemophagocytic syndrome after allogeneic blood stem cell transplantation
Publication TypeJournal Article
Year of Publication2004
AuthorsAbdelkefi A, Ben Othman T, Torjman L, Ladeb S, Lakhal A, Belhadj S, Ayari S, Cherif N, Ben Achour O, Chaker E, Ben Abdeladhim A
JournalThe hematology journal : the official journal of the European Haematology Association / EHA
Pagination449 - 450
ISSN1466-4860; 1466-4860
Accession NumberPMID: 15448674; 6200531 [pii]
KeywordsAdult, Animals, Antimalarials / therapeutic use, Blood Donors, Blood Transfusion / adverse effects, Disease Susceptibility, Erythrocytes / parasitology, Histiocytosis, Non-Langerhans-Cell / etiology, Humans, Leukemia, Myelomonocytic, Chronic / complications / therapy, Malaria, Falciparum / complications / drug therapy / transmission, Male, Parasitemia / complications / drug therapy / transmission, Peripheral Blood Stem Cell Transplantation, Plasmodium falciparum / isolation & purification, Quinine / therapeutic use, Remission Induction, Transplantation Conditioning, Transplantation, Homologous

We describe a case of Plasmodium falciparum infection in a 25-year-old male patient with a myelodysplastic syndrome, who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) in September 2003. Conditioning regimen consisted of total body irradiation (10 Gy) and cyclophosphamide 60 mg/kg for 2 days. A dose of 4 x 10(6) CD34+ cells/kg was transfused. Engraftment was well documented on day 17 post-transplantation. Spiking fevers occurred on days 19 and 21, associated with a pancytopenia, hepatosplenomegaly and neurological signs. P. falciparum parasites were found on the peripheral blood smear (parasitemia = 23%). Marrow aspiration showed P. falciparum parasites and proliferation of mature histiocytes with hemophagocytosis. Quinine 10 mg/kg i.v. three times a day for 10 consecutive days was given. The fever subsided within 3 days, and pancytopenia vanished in 14 days. Parasitemia cleared in 6 days. The patient left the unit on day 46 with no further complications. The screening of donors showed that infection was acquired from two blood units (from a single donor) given 5 days before transplantation. We report the first case of profound hemophagocytosis in immunosuppressed patient with malaria of high parasitemia after a bone marrow transplant.

Alternate JournalHematol.J.
Notify Library Reference ID1692

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