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Report of disseminated Mycobacterium haemophilum infection after double cord blood allo-SCT

Bone Marrow Transplantation volume 49, pages 1347–1348 (2014)Cite this article

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Allo-SCT predisposes recipients to opportunistic infections, including various Mycobacterium species. Whereas M. tuberculosis is the most common Mycobacterium species associated with infections, nontuberculous Mycobacterium infections have been reported at an estimated incidence of 0.16–2.8% among transplant recipients.1 M. haemophilum is a slow-growing organism first identified in 1978. Since that time, it has emerged as an unusual pathogen, but increasingly identified, and mainly involving immunocompromised patients.2 Here, we report a case of M. haemophilum infection occurring after double cord blood (CB) allo-SCT.

A 54-year-old man was diagnosed in July 2012 with AML with normal karyotype and without duplication of FLT3-ITD or mutation of NPM1 and CEBPα. He received one course of induction with a combination of idarubicin, etoposide and cytarabine allowing achievement of first cytological remission. Then, he received two courses of consolidation with idarubicin and high-dose cytarabine. Induction and consolidation courses were well tolerated without any significant infectious complication. According to local guidelines, he proceeded to allo-SCT in January 2013 with a myeloablative conditioning regimen including thiotepa (5 mg/kg/d × 2 days), i.v. BU (3.2 mg/kg/d × 3 days), fludarabine (40 mg/m2/d × 4 days) and rabbit antithymocyte globulin (2.5 mg/kg/d × 2 days). The stem cell source was two unrelated CB units (matched 4/6 with the patient and with each other, TNC=4.6 × 107/kg recipient body weight). GVHD prophylaxis consisted of CsA and mycophenolate mofetil.

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Acknowledgements

We thank the nursing staff for providing excellent care for our patients, the transplant coordination nurses and the following physicians: M Buffet, P Coppo, JP Marie, J Gay, NC Gorin, M Aoudjhane, L Garderet, J Voswinkel, MP Lemonnier, E Corre, P Hirsch, A Vekhoff, Z Marjanovic, R Adaeva, H Benredouane, M Labopin and R Belhocine for their dedicated patient care. EB was supported by educational grants from the ‘Association for Training, Education and Research in Hematology, Immunology and Transplantation’ (ATERHIT). Our group is supported by several grants from the French National Cancer Institute (PHRC, INCa to MM).

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Authors and Affiliations

  1. Service d’Hématologie clinique et Thérapie cellulaire, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France

    E Brissot, A Gomez, S Lapusan, F Isnard, O Legrand, M-T Rubio & M Mohty

  2. Université Pierre et Marie Curie, UPMC Univ Paris 06, Paris, France

    E Brissot, A Gomez, A Aline-Fardin, O Legrand, M-T Rubio & M Mohty

  3. INSERM, UMRs 938, Paris, France

    E Brissot, A Gomez, O Legrand, M-T Rubio & M Mohty

  4. Laboratoire d’Anatomo-Cyto-Pathologie, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France

    A Aline-Fardin

  5. INSERM, UMR_S893, Paris, France

    A Aline-Fardin

  6. Laboratoire de Bactériologie, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France

    V Lalande

  7. Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France

    J-L Meynard

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  1. E Brissot
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Correspondence to M Mohty.

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Brissot, E., Gomez, A., Aline-Fardin, A. et al. Report of disseminated Mycobacterium haemophilum infection after double cord blood allo-SCT. Bone Marrow Transplant 49, 1347–1348 (2014). https://doi.org/10.1038/bmt.2014.144

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