Fatal graft-versus-host disease after a small leukocyte transfusion in a patient with lymphoma and varicella.
A child with a poorly differentiated lymphoma developed varicella while being treated with maintenance chemotherapeutic agents. He received a transfusion of nonirradiated leukocytes from 1 unit of whole blood donated by a healthy volunteer who had recently recovered from varicella. The clinical course of varicella was aborted, but a classic graft-versus-host reaction developed and ultimately proved fatal. The host may have presented a large population of antigen-bearing cells to an infusion of presensitized immunocompetent donor cells, leading to an overwhelming aggressor lymphocyte reaction. We speculate that a modified approach using irradiated donor cells could be of benefit in the treatment of varicella infections in the immunosuppressed host.
D002644:Chickenpox / Q000150:complications* / Q000628:therapy*; D002648:Child; D006087:Graft vs Host Reaction; D006801:Humans; D017708:Leukocyte Transfusion; D008223:Lymphoma / Q000150:complications*; D008297:Male; D065227:Transfusion Reaction