Abstract
Although hematopoietic stem cell (HSC) products are routinely cultured for sterility, bacterial contamination of these products is rarely observed and little is known about the clinical consequences of infusing contaminated grafts. We retrieved the sterility cultures of bone marrow and peripheral HSC grafts from 938 patients transplanted at our center from January 1990 to July 2005. Fever, septicemia and other adverse events were assessed for up to 14 days following infusion of the graft. Out of the 1502 grafts collected during this 15-year period, 15 (1.0%) had a positive sterility culture (11 Gram-positive cocci, 2 Gram-positive bacilli and 2 Gram-negative bacilli). No correlation was observed between the graft contamination rate and the extent of graft manipulation or the patient's underlying condition. Thirteen recipients were transplanted with contaminated grafts. Five patients were treated with specific pre-emptive antibiotics. Only one episode of Staphylococcus epidermidis bacteremia possibly related to a contaminated graft was observed on day +5. As the infusion of contaminated grafts with Gram-positive skin contaminants rarely results in unfavorable clinical outcomes, close patient monitoring without the use of specific pre-emptive antibiotics could be appropriate and could avoid antibiotic-associated adverse events.
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References
Foundation for the Accreditation of Hematopoietic Cell Therapy. Standards for Hematopoietic Progenitor Cell Collection, Processing, and Transplantation. 1st edn. Omaha, Neb 1996; Ch.FAHCT Accreditation Office.
Progenitor Cell Standards Task Force. Standards for Hematopoietic Progenitor Cell Services. 2nd edition [American Association of Blood Banks]. Bethesda, MD, 2000, pp 22–58.
Nasser RM, Hajjar I, Sandhaus LM, Hall GS, Avery RK, Bolwell BJ et al. Routine cultures of bone marrow and peripheral stem cell harvests: clinical impact, cost analysis, and review. Clin Infect Dis 1998; 27: 886–888.
Webb IJ, Coral FS, Andersen JW, Elias AD, Finberg RW, Nadler LM et al. Sources and sequelae of bacterial contamination of hematopoietic stem cell components: implications for the safety of hematotherapy and graft engineering. Transfusion 1996; 36: 782–788.
Prince HM, Page SR, Keating A, Saragosa RF, Vukovic NM, Imrie KR et al. Microbial contamination of harvested bone marrow and peripheral blood. Bone Marrow Transplant 1995; 15: 87–91.
Rowley SD, Davis J, Dick J, Braine HG, Charache P, Saral R et al. Bacterial contamination of bone marrow grafts intended for autologous and allogeneic bone marrow transplantation. Incidence and clinical significance. Transfusion 1988; 28: 109–112.
Lazarus HM, Magalhaes-Silverman M, Fox RM, Creger RJ, Jacobs M . Contamination during in vitro processing of bone marrow for transplantation: clinical significance. Bone Marrow Transplant 1991; 7: 241–246.
Nifong TP, Ehmann WC, Mierski JA, Domen RE, Rybka WB . Favorable outcome after infusion of coagulase-negative staphylococci-contaminated peripheral blood hematopoietic cells for autologous transplantation. Arch Pathol Lab Med 2003; 127: e19–e21.
Roy DC, Griffin JD, Belvin M, Blattler WA, Lambert JM, Ritz J . Anti-MY9-blocked-ricin: an immunotoxin for selective targeting of acute myeloid leukemia cells. Blood 1991; 77: 2404–2412.
Roy DC, Perreault C, Bélanger R, Gyger M, Le Houillier C, Blättler WA et al. Elimination of B-lineage leukemia and lymphoma cells from bone marrow grafts using anti-B4-blocked-ricin immunotoxin. J Clin Immunol 1995; 15: 51–57.
Roy DC, Dallaire N, Moreau B, Paquette Y, Balassy A, Giorgi O et al. Photodynamic therapy of B-lineage non-Hodgkin's lymphoma and chronic lymphocytic leukemia. Blood 2000; 96: 793a.
Roy DC, Boileau J, Laplante J, Busque L, Fish D, Kassis J et al. Phase I study of autologous progenitor cell transplantation purged with a photodynamic approach for patients with chronic myeloid leukemia. Blood 2000; 96: 583a.
Roy DC . Purging of leukemia cells with a photodynamic approach. Leuk Lymphoma 1998; 30: 50.
Andre-Schmutz I, le DF, Hacein-Bey-Abina S, Vitetta E, Schindler J, Chedeville G et al. Immune reconstitution without graft-versus-host disease after haemopoietic stem-cell transplantation: a phase 1/2 study. Lancet 2002; 360: 130–137.
Dal-Cortivo L, Ouachee-Chardin M, Hirsch I, Blanche S, Fischer A, Cavazzana-Calvo M et al. Does haploidentical transplantation in children with primary immunodeficiencies have the potential to exploit donor NK cell alloreactivity? Bone Marrow Transplant 2004; 34: 945–947.
Guimond M, Balassy A, Barrette M, Brochu S, Perreault C, Roy DC . P-glycoprotein targeting: a unique strategy to selectively eliminate immunoreactive T cells. Blood 2002; 100: 375–382.
Sidi Boumedine R, Roy DC . Elimination of alloreactive T cells using photodynamic therapy. Cytotherapy 2005; 7: 134–143.
York MK, Thomson RB . Body fluid cultures (excluding blood, cerebrospinal fluid and urine). In: Isenberg HD (ed). Clinical Microbiology Procedures Handbook, chapter 3.5.1, 2nd edn. ASM Press: Cleveland, OH, 2004.
Khuu HM, Cowley H, David-Ocampo V, Carter CS, Kasten-Sportes C, Wayne AS et al. Catastrophic failures of freezing bags for cellular therapy products: description, cause, and consequences. Cytotherapy 2002; 4: 539–549.
Acknowledgements
We thank C LeHouillier, M Corriveau and all the personnel of the Cellular Therapy and Microbiology Laboratories for their contribution, and Dr Carlos Patino for retrieving data from the patients' charts. Dr Carlos Patino is supported by an unrestricted grant from Astella Pharma Canada Inc. This study was supported in part by a grant from the Fonds de la Recherche en Santé du Québec.
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Kelly, M., Roy, DC., Labbe, A. et al. What is the clinical significance of infusing hematopoietic cell grafts contaminated with bacteria?. Bone Marrow Transplant 38, 183–188 (2006). https://doi.org/10.1038/sj.bmt.1705421
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DOI: https://doi.org/10.1038/sj.bmt.1705421
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