12th Congress of the European Hematology ... - Haematologica

due to reactivation and/or progression of IFI. In 2 patients, IFI was treated
two antifungal drugs and also granulocyte infusion (n=1). There was
no difference for engraftment kinetics, the frequencies of transplantationrelated
mortality and acute graft-versus host disease and three-month the
probability of survival between group 1 and group 2. Only one patient
died of progressive IFI after the transplantation in each group. No significant
differences of transplant outcomes in patients with high probability
or active IFI in each group were also found. Conclusions. Our data
showed that the history of IFI and also active infection was not absolute
contraindication for a transplantation program. So the decision of transplantation
should be given according to the biological behavior of the
underlying disease individually, not the characteristic of IFI alone.
Table 1.
Group 1 Group 2 p
Median age
Diagnosis
21(19-51) 23(16-53)
Acute leukemia 16 8
Chronic leukemia 3 3
Aplastic anemia - 4
MDS/Lymphoma/MM/PNH 1/1/0/0 2/1/4/1
Conditioning regimen 20 21
Myeloablative
Non-Myeloablative
1 2
Dead due IFI 1/21 1/23
Engraftment 17/21 21/23 0.403
Neutrophil 11.4 ng/mL). In addition, multiparametric flow cytometric analysis
(5- or 6-color combinations of monoclonal antibodies) was applied to
BM samples to identify MCs (CD45 + /CD117 + /CD34 - ) and to evaluate
abnormal expression of CD25 and CD2 on MCs (total cell number analyzed:
1,000.000). Finally, we assessed the presence of D816V KIT mutation
in BM mononuclear cells by restriction fragment length polymorphism
analysis, using Hinf I on RT-PCR product corresponding to the
second tyrosine kinase domain of c-Kit; the same PCR product was then
sequenced to confirm the presence of the D816V mutation. Results. Basal
serum tryptase levels were increased (median 16.9 ng/mL; range 11.8-103
ng/mL) in 34/276 patients (12.3%). Ten of these patients were studied
with BM analysis (Table 1). Nine/10 patients had previous severe anaphylactic
reactions (type III: 3 cases, type IV: 6 cases) and one had reaction
of type I. BM immunohistochemistry showed typical infiltrates of
tryptase+ spindle-shaped cells in 5/10 patients (50%). The KIT point
mutation D816V was found in 5 (50%) cases. Six/10 (60%) patients
showed atypical MCs in BM smear. In all cases, BM CD117 ++ MCs, eval-
haematologica/the hematology journal | 2007; 92(s1) | 391