Annals of Hematology

, Volume 91, Issue 3, pp 475–476 | Cite as

Acquired severe aplastic anemia after H1N1 influenza virus vaccination successfully treated with allogeneic bone marrow transplantation

  • Irene DonniniEmail author
  • Barbara Scappini
  • Stefano Guidi
  • Giovanni Longo
  • Alberto Bosi
Letter to the Editor

Dear Editor,

Here, we report a case of acquired severe aplastic anemia (SAA) which occurred in a young man potentially correlated to the administration of H1N1 influenza virus vaccine. On 30 November 2009, a 25-year-old man presented to ER with fever, headache, sore throat and diffuse bruises. Laboratory tests revealed severe pancytopenia (WBC 1.2 × 109/L, haemoglobin 11.2 g/dL and platelets 3,000 × 109/L).

He was immediately referred to our institution. Liver and renal functions were normal as well as coagulation parameters. Medical history was completely negative with the exception that he received vaccination for H1N1 virus few days before, on 15 November 2009 (Focetria, lot number # 090201). He was completely healthy before. The only reason why his family doctor suggested this specific vaccination was because he worked as a salesman, travelling abroad frequently.

All microbiological tests, including blood cultures, were repeatedly negative, and fever was responsive to a broad...


Aplastic Anaemia Filgrastim Paroxysmal Nocturnal Haemoglobinuria H1N1 Influenza Virus Severe Aplastic Anemia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Kaufman DW, Kelly JP, Issaragrisil S, Laporte JR, Anderson T, Levy M et al (2006) Relative incidence of agranulocytosis and aplastic anemia. Am J Hematol 81:65–67PubMedCrossRefGoogle Scholar
  2. 2.
    Choudhry VP, Gupta S, Gupta M, Kashyap R, Saxena R (2002) Pregnancy associated aplastic anemia: a series of 10 cases with review of literature. Hematolgy 7:233–238CrossRefGoogle Scholar
  3. 3.
    Lu J, Basu A, Melenhorst J, Young NS, Brown KE (2004) Analysis of T-cell repertoire in hepatitis-associated aplastic anemia. Blood 103:4588–4593PubMedCrossRefGoogle Scholar
  4. 4.
    Bacigalupo A (1996) Aetiology of severe aplastic anaemia and outcome after allogeneic bone marrow transplantation or immunosuppression. Eur J Haematol 57(suppl 60):16–19Google Scholar
  5. 5.
    Kaufman DW, Kelly JP, Levy M, Shapiro S (1991) The drug etiology of agranulocytosis and aplastic anemia. Oxford, New YorkGoogle Scholar
  6. 6.
    Brodsky RA, Jones RJ (2005) Aplastic anaemia. Lancet 365:1647–1656PubMedCrossRefGoogle Scholar
  7. 7.
    Young NS, Calado RT, Scheinberg P (2006) Current concepts in the pathophysiology and treatment of aplastic anemia. Blood 108:2509–2519PubMedCrossRefGoogle Scholar
  8. 8.
    Peng J, Liu C, Zhu K et al (2003) The TNF2 allele is a risk factor to severe aplastic anemia independent of HLA-DR. Hum Immunol 64:896–901PubMedCrossRefGoogle Scholar
  9. 9.
    Demeter J, Messer G, Schrezenmeier H (2002) Clinical relevance of the TNF-alpha promoter/enhancer polymorphism in patients with aplastic anemia. Ann Hematol 81:566–569PubMedCrossRefGoogle Scholar
  10. 10.
    Dufour C, Capasso M, Svahn J et al (2004) Homozygosis for (12) CA repeats in the first intron of the human IFN-gamma gene is significantly associated with the risk of aplastic anaemia in Caucasian population. Br J Haematol 126:682–685PubMedCrossRefGoogle Scholar
  11. 11.
    Young NS, Alter BP (1994) Aplastic anaemia: acquired and inherited. Saunders, PhiladelphiaGoogle Scholar
  12. 12.
    Viallard J-F, Boiron J-M, Parrens et al (2000) Severe pancytopenia triggered by recombinant hepatitis B vaccine. Br J Haematol 110:230–233PubMedCrossRefGoogle Scholar
  13. 13.
    Hendry CL, Sivakumaran M, Marsh JC, Gordon-Smith EC (2002) Relapse of severe aplastic anaemia after influenza immunization. Br J Haematol 119(1):283–284PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Irene Donnini
    • 1
    Email author
  • Barbara Scappini
    • 1
  • Stefano Guidi
    • 1
  • Giovanni Longo
    • 1
  • Alberto Bosi
    • 1
  1. 1.Haematology Unit and Bone Marrow Trasplantation SectionUniversity of Florence and Careggi HospitalFlorenceItaly

Personalised recommendations