Bone marrow engraftment analysis after granulocyte transfusion

Sharon L. Swierczynski, Michael J. Hafez, Juliet Philips, Meghan A. Higman, Karin D. Berg, Kathleen M. Murphy

Research output: Contribution to journalArticle

Abstract

We present the case of a 6-year-old male who received an allogeneic bone marrow transplant as part of treatment for acute lymphoblastic leukemia. The patient relapsed 5 months after transplantation and received additional chemotherapy. He acquired an angioinvasive fungal infection that required transfusion of granulocytes. Approximately 5 weeks after relapsing (181 days after transplant), a bone marrow specimen was taken for molecular engraftment analysis and flow cytometry to assess graft loss as well as residual disease. The engraftment results generated by the multiple short tandem repeat loci tested were inconsistent, and alleles were present at several loci that were of neither patient nor donor origin. An error in specimen identification was initially considered. Further investigation into the circumstances surrounding procurement of the patient's bone marrow aspirate revealed that the patient bad received a granulocyte transfusion approximately 10 hours before the bone marrow specimen was taken. In addition, morphological and flow cytometric analyses of the same bone marrow aspirate demonstrated a significant degree of peripheral blood contamination. We determined that the unknown alleles in the bone marrow engraftment specimen were derived from the donor of the transfused granulocytes. This case illustrates that white cell transfusion can lead to erroneous bone marrow engraftment results, particularly if only one microsatellite locus is used to monitor engraftment.

Original languageEnglish (US)
Pages (from-to)422-426
Number of pages5
JournalJournal of Molecular Diagnostics
Volume7
Issue number3
StatePublished - Aug 2005

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Granulocytes
Bone Marrow
Transplants
Microsatellite Repeats
Alleles
Tissue Donors
Mycoses
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Flow Cytometry
Transplantation
Drug Therapy

ASJC Scopus subject areas

  • Molecular Biology

Cite this

Swierczynski, S. L., Hafez, M. J., Philips, J., Higman, M. A., Berg, K. D., & Murphy, K. M. (2005). Bone marrow engraftment analysis after granulocyte transfusion. Journal of Molecular Diagnostics, 7(3), 422-426.

Bone marrow engraftment analysis after granulocyte transfusion. / Swierczynski, Sharon L.; Hafez, Michael J.; Philips, Juliet; Higman, Meghan A.; Berg, Karin D.; Murphy, Kathleen M.

In: Journal of Molecular Diagnostics, Vol. 7, No. 3, 08.2005, p. 422-426.

Research output: Contribution to journalArticle

Swierczynski, SL, Hafez, MJ, Philips, J, Higman, MA, Berg, KD & Murphy, KM 2005, 'Bone marrow engraftment analysis after granulocyte transfusion', Journal of Molecular Diagnostics, vol. 7, no. 3, pp. 422-426.
Swierczynski SL, Hafez MJ, Philips J, Higman MA, Berg KD, Murphy KM. Bone marrow engraftment analysis after granulocyte transfusion. Journal of Molecular Diagnostics. 2005 Aug;7(3):422-426.
Swierczynski, Sharon L. ; Hafez, Michael J. ; Philips, Juliet ; Higman, Meghan A. ; Berg, Karin D. ; Murphy, Kathleen M. / Bone marrow engraftment analysis after granulocyte transfusion. In: Journal of Molecular Diagnostics. 2005 ; Vol. 7, No. 3. pp. 422-426.
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