ABSTRACT
CD147 (BSG, EMMPRIN) is a multifunctional immunoglobulin involved in pathogenesis of many diseases. It was shown to facilitate various viral infections, such as measles virus and SARS-CoV-2, and was reported to have a role in cytomegalovirus (CMV) infection. While mostly working as a membrane-bound protein, it can be released by cells in a soluble form that can be detected in serum. Our recent studies showed that CD147 polymorphism and serum level may be associated with risk and survival in acute myeloid leukemia (AML) patients. This prompted us to investigate CD147 serum levels and genotypes in AML patients with CMV infection after allogeneic stem cell transplantation (SCT). CD147 was measured using Quantikine ELISA Human EMMPRIN/ CD147 Immunoassay in serum of 16 AML patients undergoing SCT, of whom nine developed CMV infection, and 25 controls. Genotyping of CD147 variants was performed on 170 DNA samples, including 135 healthy individuals and 35 patients (18 with CMV infection) using Taqman assays. Serum CD147 levels were higher in patients with CMV infection than in those without detectable CMV infection (p = 0.026) and controls (p < 0.001). CD147 allele rs4919859C, a marker of risk and worse survival in AML, tended to be more common in patients with CMV infection than those without infection (p = 0.094). Furthermore, we built a logistic regression model incorporating the type of conditioning, sex of transplant donor and recipient, type of donor (related/ unrelated), donor and recipient serologic CMV status, and presence/absence of the rs4919859 C allele. The analysis confirmed allele rs4919859 C (p = 0.044) and recipient CMV status (p = 0.035) as independent markers of CMV infection. Our results suggest that higher serum CD147 levels and presence of the CD147 rs4919859C allele may be markers of CMV infection in AML patients undergoing SCT.
ABSTRACT
Infections are still one of the most common causes of death after hematopoietic cell transplantation (HCT). Antimicrobial prophylaxis plays a crucial role in decreasing non-relapse mortality after HCT. The objective of this guideline paper was the presentation of current recommendations of antimicrobial prophylaxis for children and adults after hematopoietic cell transplantation, prepared in cooperation with Polish scientific hematological societies. Recommendations were prepared by the working group and finally approved by all 23 Polish transplant centers for children and adults. Existing (European Conference on Infections in Leukemia (ECIL) and European Society of Blood and Marrow Transplantation (EBMT) guidelines, as well as the results of a survey performed among all Polish transplant centers, were the background material for the working group. Recommendations are presented in sections dedicated to antibacterial prophylaxis, antifungal prophylaxis, antiviral prophylaxis, as well as prophylaxis of toxoplasmosis and infections with Pneumocystis jiroveci. Recommendations on the principles of vaccination against COVID-19 are provided based on the state of knowledge in September 2021. A section on guidelines of environmental prophylaxis is also presented.
ABSTRACT
Background: Bone marrow donation is a procedure that takes place in a hospital operating room. In many hospitals, autologous red cell units are collected from donor before the harvest and reinfused immediately after the donation to reduce the risk of anemia. The blood donation stimulates hematopoiesis, so it's possible that autotransfusion has an impact on number of collected cells. The aim of this study is to assess whether blood donation before the harvest has an impact on the total number of nucleated cells in the product. Methods: Study design: Most of the donors undergo preharvest autologous blood collection. The procedure was not carried out if the weight difference is greater than 30kg in favor of the donor. Until March 2020, due to COVID-19, routine blood donations for autotransfusion were suspended. This situation gave an opportunity to assess, if the donation of blood has an impact on the efficiency of BM collection and hemoglobin level in donors' blood after harvest. Bone marrow was aspirated under general anesthesia, from both pelvic bones. According to the local protocol the volume of marrow and WBC was measured during donation;if the total number of nucleated cells was sufficient, the donation was finished. The collection was also completed, if the total volume of BM reached 15 ml per kg of donor's body weight. Laboratory analyses: The blood samples for morphology analyses were taken in the day of qualification, one day before and one day after harvest. The samples of BM were taken during donation to measure number of lymphocytes. Statistics: TheMann-Whitney U-test was used to determine the significance between the cohorts. Differences with p values <0.05 were considered as statistically significant. Results: Between March and October 2020, 15 BM donations from 15 healthy donors (10 men and 5 women, median age: 35 years, range 20-49 years) were performed;these donors were not referred for autotransfusion. The control group consisted of 34 donors, who underwent harvest between January 2019 and March 2020 (23 men and 11 women, median age 25 years, range 18-41 years). Total volume collected BM was comparable in both groups (median: 1182 ml in first vs 1277 ml in control group). The level of hemoglobin on the day of qualification was similar in both group: median 15.2 g/dL for donors who had blood donation;and 15.4 g/dL, for donors not referred to autotransfusion. One day before harvest, the first group had statistically lower level of hemoglobin (median 14.1 g/dL vs 14.8 g/dL, p < 0.001), however one day after BM collection both groups were comparable (median 11.1 g/dL vs 11.5 g/dL). Total number of nucleated cells in the product was comparable in both groups: median 204 × 108 in donors referred for autotransfusion vs 219 × 108 in control group. Conclusions: Autologous blood transfusion had no impact on Hb levels in blood after BM donation and had no impact on the efficiency of BM harvest. This does not support the routine use of autologous blood transfusion for unrelated BM donors.