Transfusion-Associated HIV Infection in Pediatric Leukemia Patients (Two Case Reports)
Case 1: A 13-year-1-month old boy weighing 50.5 kg was admitted to our hospital on September 15, 2008 because of 2 weeks of fatigue and pallor associated with 1 week of chest distress. Bone marrow aspiration was carried out immediately. The complete blood count (CBC) of emergency showed white blood cells (WBC) 16.2×109/L, N 11.4%, Hb 75 g/L, Plt 79×109/L. The diagnosis was acute lymphocyte leukemia (ALL) with L2, common-B and middle risk according to the results of bone marrow cytomorphology examination, flow cytometry immunophenotyping (FCMI) and CBC. From September 17 to December 17, 2008, the chemotherapy was carried out sequentially. During the chemotherapy, when the hemoglobin was below 70g/L and/or platelets below 20×109/L, red blood cells (RBC) and/or platelets were transfused respectively, and fresh frozen plasma was used when dysfunction of blood coagulation was detected. He was multi-transfused with 16 U RBC, 20 U platelets and 820 ml fresh frozen plasma. During each hospitalization, screen tests of rapid plasma reagin (RPR), antibody of HIV (HIV-Ab) and hepatitis viruses were carried out. On February 1, 2009, he was admitted again for consolidation chemotherapy. Before transfusion, his blood sample was positive for HIV antibody [human immunodeficiency virus antibody diagnosis reagents (double antigen-binding enzyme-linked immunosorbent assay), INTEC (Xiamen) technology Ltd. LOT: 2008066607]. The result was confirmed by the Center for Disease Control (CDC) (HIV 1/2 Antibody Immunoblot Kit, MP Biomedicals Asia Pacific Pte. Ltd. Lot: AE8034). After retesting of blood products that this patient had received before, it was confirmed that the first used FFP carried the HIV. There was no transfusion before the diagnosis of ALL, no operation and infectious disease in his past history. The history of preventive vaccinations was normal. His parents and elder brother were healthy, with negative HIV screen tests.